Volume 29, Issue 165, November 2025

Rapid progression of HPV16 infection to high-grade cervical intraepithelial neoplasia (CIN3) in a young woman: a case report

Katarzyna Bielawska^1♦, Wiktoria Julia Auguścik¹, Aleksandra Tlak², Julia Charkot¹, Wojciech Jędrzej Bieńkowski¹

¹Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland
²Medical University of Łódź, 4 Tadeusza Kościuszki Street, 90-419 Łódź, Poland

^♦Corresponding author
Katarzyna Bielawska, Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland

ABSTRACT

The main etiological factor of cervical intraepithelial neoplasia (CIN) and cervical cancer is persistent infection with oncogenic types of human papillomavirus (HPV). Most HPV infections regress spontaneously, while progression to high-grade lesions usually takes several years. We describe the case of a 24-year-old woman, unvaccinated against HPV, who had a very rapid progression of HPV16 infection — from a normal cervical cytology result to histologically confirmed CIN3 within nine months. The patient presented no clinical symptoms and regularly attended cervical cancer screening, i.e., cytology. A Pap smear performed in December 2022 revealed no signs of dysplasia, but nine months later, an LBC cytology test revealed ASC-H with suspected HSIL, and HPV DNA testing confirmed HPV16 infection. A Colposcopy identified suspicious areas and biopsies confirmed CIN3. Histopathology after the first Loop Electrosurgical Excision Procedure (LEEP) showed CIN3 with positive margins. After the first LEEP procedure, the patient started a course of Gardasil-9 vaccinations. Because positive margins persisted, the gynecologist repeated the LEEP twice. The second procedure revealed CIN2 with a positive surgical margin, while the third showed the absence of intraepithelial neoplasia. In April 2025, a control LBC cytology test showed no neoplastic changes, and an HPV test result was negative. This case is remarkable due to the patient's age and rapid the HPV16 progression. The case emphasizes the role of molecular biomarkers in risk assessment and the importance of HPV vaccination in primary prevention.

Keywords: cervical intraepithelial neoplasia; human papillomavirus type 16; cervical screening; loop electrosurgical excision procedure; surgical margins

Medical Science, 2025, 29, e214ms3733

PDF

DOI: https://doi.org/10.54905/disssi.v29i165.e214ms3733

Published: 18 November 2025