Page 745 - Textbook of Pathology, 6th Edition

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Figure 24.7 Invasive carcinoma of the cervix common gross appear-
ance is of a fungating or exophytic, cauliflower-like tumour. Gross
photograph on right shows replacement of the cervix by irregular grey-
white friable growth (arrow) extending into cervical canal as well as distally
into attached vaginal cuff.

countries with low living standards. The risk factors and nodes. Distant metastases occur in the lungs, liver, bone
etiologic factors are the same as for CIN discussed above. marrow and kidneys.
The peak incidence of invasive cervical cancer is in 4th to Histologically, the following patterns are seen: CHAPTER 24
6th decades of life.
1. Epidermoid (Squamous cell) carcinoma. This type
MORPHOLOGIC FEATURES. Grossly, invasive cervical comprises vast majority of invasive cervical carcinomas
carcinoma may present 3 types of patterns: fungating, (about 70%).
ulcerating and infiltrating. The fungating or exophytic The most common pattern (70%) is moderately-
pattern appearing as cauliflower-like growth infiltrating differentiated non-keratinising large cell type and has
the adjacent vaginal wall is the most common type better prognosis (Fig. 24.8).
(Fig. 24.7). Characteristically, cervical carcinoma arises Next in frequency (25%) is well-differentiated kerati-
from the squamocolumnar junction. The advanced stage nising epidermoid carcinoma.
of the disease is characterised by widespread destruction Small cell undifferentiated carcinoma (neuroendocrine
and infiltration into adjacent structures including the or oat cell carcinoma) is less common (5%) and has a poor The Female Genital Tract
urinary bladder, rectum, vagina and regional lymph prognosis.

Figure 24.8 Invasive cancer cervix. Common histologic type is epidermoid (squamous cell) carcinoma showing the pattern of a moderately-
differentiated non-keratinising large cell carcinoma.