What are the other Names for the Condition? (Also known as/Synonyms)

• SMILE (Stratified Mucin-Producing Intraepithelial Lesion)

What is Stratified Mucin-Producing Intraepithelial Lesion? (Definition/Background Information)

• Stratified Mucin-Producing Intraepithelial Lesion (SMILE) is a rare and distinctive high-grade cervical precancerous lesion that has been designated as a variant of adenocarcinoma in situ (AIS) in the World Health Organization (WHO) classification
• The condition can affect women of reproductive age. The cause of formation of Stratified Mucin-Producing Intraepithelial Lesion is presently unknown but some of the contributory factors include persistent HPV infections and poor immunity
• The lesion may not cause noticeable symptoms in many women but may sometimes present abnormal vaginal discharge and bleeding. A diagnosis of Stratified Mucin-Producing Intraepithelial Lesion involves physical examination, Pap smear testing, and a biopsy, if required
• Since a lack of treatment may result in cervical cancer, Stratified Mucin-Producing Intraepithelial Lesion is surgically removed. The prognosis is generally good with early diagnosis and appropriate treatment of SMILE, including regular follow-up checkups
• While it may not always cause noticeable signs or symptoms, regular cervical screening and HPV vaccination can play a significant role in detecting and preventing the progression of Stratified Mucin-Producing Intraepithelial Lesion to invasive cervical cancer

Who gets Stratified Mucin-Producing Intraepithelial Lesion? (Age and Sex Distribution)

• Stratified Mucin-Producing Intraepithelial Lesion is a rare cervical precancerous lesion that can affect women of reproductive age (between 15 and 49 years)
• No racial or ethnic group preference is reported

What are the Risk Factors for Stratified Mucin-Producing Intraepithelial Lesion? (Predisposing Factors)

While it can occur in women without any specific risk factors, certain factors may increase the likelihood of developing Stratified Mucin-Producing Intraepithelial Lesion, including:

• Persistent infection with high-risk types of human papillomavirus (HPV) such as subtypes 16 and 18
• History of previous cervical dysplasia or cervical cancer
• Immunocompromised state, such as in women with HIV infection or AIDS or those undergoing immunosuppressive therapy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Stratified Mucin-Producing Intraepithelial Lesion? (Etiology)

Currently, the exact cause of Stratified Mucin-Producing Intraepithelial Lesion (SMILE) is not well understood.

• However, it is believed to be associated with persistent infection by high-risk types of human papillomavirus (HPV), particularly HPV subtypes 16 and 18
• Other risk factors for developing SMILE may include a history of previous cervical dysplasia or cervical cancer and immunosuppression

Stratified Mucin-Producing Intraepithelial Lesion (SMILE) is an uncommon cervical lesion characterized by the production of mucin by the abnormal cells within the cervical epithelium. It is considered a high-grade precancerous lesion and is classified as a variant of adenocarcinoma in situ (AIS) in the WHO classification of cervical tumors.

What are the Signs and Symptoms of Stratified Mucin-Producing Intraepithelial Lesion?

In many cases, Stratified Mucin-Producing Intraepithelial Lesion may not cause noticeable signs or symptoms. It is often detected incidentally during routine cervical screening. However, in some cases, women with SMILE may experience the following:

• Abnormal vaginal bleeding, such as postcoital bleeding or bleeding between periods
• Unusual vaginal discharge, which may be watery, bloody, or foul-smelling

How is Stratified Mucin-Producing Intraepithelial Lesion Diagnosed?

The diagnosis of Stratified Mucin-Producing Intraepithelial Lesion (SMILE) typically involves the following:

• Pap smear: A Pap smear is a screening test used to detect abnormal cells in the cervix. SMILE may be detected incidentally during routine Pap smear testing
• Colposcopy: If abnormal cells are detected on a Pap smear, a colposcopy may be performed. During this procedure, a healthcare provider examines the cervix using a specialized magnifying instrument called a colposcope to closely assess any abnormal areas
• Biopsy: If suspicious or abnormal areas are identified during colposcopy, a biopsy may be performed. This involves the removal of a small tissue sample from the affected area of the cervix for further examination under the microscope by a pathologist

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Stratified Mucin-Producing Intraepithelial Lesion?

If left untreated or undetected, Stratified Mucin-Producing Intraepithelial Lesion (SMILE) can lead to several complications, including:

• Progression to invasive cervical cancer: SMILE is considered a high-grade precancerous lesion. If not appropriately managed, it may progress to invasive cervical cancer over time
• Spread of cancer cells: In advanced cases, the lesion can invade nearby tissues and organs, resulting in local spread and distant metastasis

How is Stratified Mucin-Producing Intraepithelial Lesion Treated?

The treatment of Stratified Mucin-Producing Intraepithelial Lesion (SMILE) aims to remove or destroy abnormal cells to prevent the development of invasive cervical cancer.

The treatment options may include:

• Loop electrosurgical excision procedure (LEEP): LEEP is a common surgical technique used to remove abnormal cervical tissue. It involves the use of a thin, wire loop heated by an electrical current to excise the affected area
• Cold knife conization: This surgical procedure involves the removal of a cone-shaped piece of abnormal cervical tissue using a scalpel or laser. It allows for a more extensive examination of the abnormal cells and can be used for both diagnostic and therapeutic purposes
• Hysterectomy: In cases where SMILE is extensive, recurrent, or if there are other factors influencing the decision, a surgical removal of the uterus (hysterectomy) may be recommended

How can Stratified Mucin-Producing Intraepithelial Lesion be Prevented?

While it may not be possible to prevent Stratified Mucin-Producing Intraepithelial Lesion (SMILE) completely, certain measures can help reduce the risk of developing cervical precancerous lesions, including SMILE:

• Human papillomavirus (HPV) vaccination: Vaccination against high-risk HPV subtypes, such as HPV 16 and 18, can significantly reduce the risk of HPV infection and related precancerous lesions, including SMILE. Vaccination is recommended for both males and females, ideally before sexual activity begins
• Regular cervical screening: Routine cervical screening, such as Pap smears or HPV testing, can detect early changes in the cervix and help identify precancerous lesions, including SMILE. Regular screening allows for timely intervention and treatment if abnormalities are detected
• Safe sexual practices: Practicing safe sex, including consistent condom use, can reduce the risk of acquiring HPV infection
• Avoiding tobacco use: Smoking has been associated with an increased risk of cervical precancerous lesions, including SMILE. Quitting smoking can contribute to overall cervical health

It is important for individuals to consult with healthcare providers for personalized recommendations and guidance on cervical cancer screening and prevention strategies based on their individual risk factors and medical history.

What is the Prognosis of Stratified Mucin-Producing Intraepithelial Lesion? (Outcomes/Resolutions)

The prognosis for Stratified Mucin-Producing Intraepithelial Lesion (SMILE) depends on various factors, including the extent of the lesion, the presence of associated abnormalities, and the effectiveness of treatment.

• When diagnosed and treated early, the prognosis for SMILE is generally good, with a low risk of progression to invasive cervical cancer
• Although, regular follow-up and surveillance are important to monitor for recurrence or development of new lesions

Additional and Relevant Useful Information for Stratified Mucin-Producing Intraepithelial Lesion:

The following link is a useful resource for information on cancers and benign tumors on DoveMed:

https://www.dovemed.com/diseases-conditions/cancer/