Case Report: Possible spatially-distinct de novo invasive cervical carcinoma in the setting of isolated persistent HPV16 after ALA-PDT-mediated histological clearance of CIN3 - Report - MDSpire
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Case Study: Potentially Spatially-Separated De Novo Invasive Cervical Carcinoma Following Isolated Persistent HPV16 After Histological Clearance of CIN3 via ALA-PDT

  • By

  • Huihui Cai

  • Yanci Che

  • Yutong Liu

  • Jing Wang

  • Tingting Ma

  • Rui Yao

  • September 8, 2026

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Clinical Report: Potentially Spatially-Separated De Novo Invasive Cervical Carcinoma

Overview

This case report highlights the risk of de novo invasive cervical carcinoma in a patient with isolated persistent HPV16 following histological clearance of CIN3 via ALA-PDT.

Background

Cervical intraepithelial neoplasia grade 3 (CIN3) is a high-grade precancerous condition, and 5-aminolaevulinic acid-mediated photodynamic therapy (ALA-PDT) is an organ-preserving treatment option for young patients. Despite successful treatment, persistent high-risk HPV, particularly HPV16, poses a risk for malignant transformation.

Data Highlights

No numerical data or trial data provided in the article.

Key Findings

  • A 32-year-old woman developed invasive squamous cell carcinoma after histological remission of CIN3.
  • The carcinoma was located in a cervical quadrant spatially separate from the initial CIN3 lesions.
  • Persistent isolated HPV16 infection was documented despite the resolution of CIN3.
  • Long-term loss to follow-up (LTFU) was noted, with the patient not returning for surveillance for 20 months.
  • The case suggests a potential link between persistent HPV16 and de novo malignant transformation.

Clinical Implications

Healthcare providers should emphasize the importance of regular follow-up for patients treated for CIN3, especially those with persistent HPV16.

Conclusion

This case underscores the potential risks associated with persistent HPV16 after CIN3 treatment.

Related Resources & Content

  1. ASCCP, ASCCP Risk-Based Management Consensus, 2019 -- Essential Changes From Prior Management Guidelines
  2. Frontiers in Oncology, 2026 -- Evaluation of efficacy and optimal therapeutic parameters of ALA-PDT in the management of HPV-associated cervical intraepithelial neoplasia grade I
  3. The ASCO Post, November 2023 -- Early-Stage Cervical Cancer: Defining Follow-up After Fertility-Sparing Surgery
  4. IARC, CERVICAL CANCER -- Global Screening Programs and Guidelines
  5. the asco post — Early-Stage Cervical Cancer: Defining Follow-up After Fertility-Sparing Surgery
  6. the asco post — HPV ctDNA Detection After Chemoradiation in Patients With Cervical Cancer
  7. Box 1. Essential Changes From Prior Management Guidelines
  8. CERVICAL CANCER
  9. Photodynamic therapy for high-grade squamous intraepithelial lesions: A randomized controlled trial - ScienceDirect

Original Source(s)

Case Report: Possible spatially-distinct de novo invasive cervical carcinoma in the setting of isolated persistent HPV16 after ALA-PDT-mediated histological clearance of CIN3

  • by Huihui Cai, Yanci Che, Yutong Liu, Jing Wang, Tingting Ma, Rui Yao

  • September 8, 2026

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