SQUAMOUS CELL CARCINOMA (Robbins pp 1051, Figs: 24-22)

General: 80% of the cancers of the cervix are of the squamous type. 15% are adenocarcinomas, & 5% are other types.

Epidemiology: Peak incidence is @ 45 years for invasive cancer, and @ 30 years for CIN III.

Clinical features / course: The clinical course of the disease is over many years. Patients may be asymptomatic. Pap smears are recommended every year after sexually active. Cytologic examination merely detects an abnormality, whether it be cancer or CIN. Diagnosis comes after specimens are retrieved for histological examination. Colposcopic examination also reveals the macroscopic view: punctuated irregularities of mucosa. When disease is obvious symptomology is: irregular vaginal bleeding, leukorrhea (whitish discharge), pain on coitus, dysuria.

Morphology: Cervical carcinomas exists in three forms: 1) exophytic, 2) infiltrative, 3) ulcerative. Microscopically: You can see large squamous cells with atypia throughout all layers of the epithelium (squamous variety). The cancer is of squamous (arise from epithelium), adenocarcinoma (arise from endocervical glands), adenosquamous (arise from reserves cells of basal layer of epithelium) variety. There are various staging classifications (Read Robbins pp 1052/3). Cervical cancer (like other structures) can spread locally (vagina, uterus, bladder, rectum) or distally (bones, lungs, liver, brain, lymph nodes).

Treatment: Invasive cancers result in hysterectomy with radiation.

Category: Pathology Notes