Invasive cervical carcinoma
- Lesion
Most cervical cancers are squamous and HPV-driven; they spread sideways into the tissues around the uterus, where they can block the ureters.
What it is
Invasive cervical carcinoma begins when an HPV-driven lesion breaks through the basement membrane, usually at the transformation zone. About three quarters are squamous cell carcinomas, most of the rest are adenocarcinomas, and a few are adenosquamous or high-grade neuroendocrine carcinomas. The tumour spreads directly into the parametria, vagina, bladder and rectum, and through pelvic lymph nodes; obstruction of the ureters is a classic cause of kidney failure and death in advanced disease.
Structure
- Gross: an exophytic friable mass, an ulcer, or a deeply infiltrative tumour that hardens and expands the cervix (barrel-shaped) with little surface change.
- Squamous: nests and tongues of keratinizing or non-keratinizing squamous cells in a desmoplastic, inflamed stroma.
- Adenocarcinoma: crowded atypical endocervical-type glands with mucin, often with adenocarcinoma in situ nearby.
- Neuroendocrine: sheets of small cells with scant cytoplasm and molded nuclei, many mitoses and necrosis; synaptophysin and chromogranin positive.
Step by step
- Persistent high-risk HPV produces HSIL or adenocarcinoma in situ in the transformation zone.
- Further host changes let tumour cells cross the basement membrane: superficial (microscopic) invasion first.
- The tumour infiltrates the cervical stroma, then the parametria, vagina and uterine corpus.
- Lymphatic spread reaches pelvic nodes and then para-aortic nodes.
- Advanced disease surrounds the ureters (hydronephrosis, renal failure) and invades bladder or rectum (fistulas).
Markers
- p16
- p40 and p63 (squamous)
- Synaptophysin and chromogranin (neuroendocrine)
Clinical notes
- Early invasive cancer is silent; later it causes postcoital or irregular bleeding, discharge, pelvic pain and urinary or bowel symptoms.
- Treatment depends on stage: surgery for small early tumours, chemoradiation for locally advanced disease.
- In Colombia and the rest of Latin America, cervical cancer is still a leading cause of cancer death in young women, concentrated where screening and follow-up are weak.
Test yourself
Think of the answer, then tap the question to see it.
What is the most common histologic type of cervical carcinoma?
Squamous cell carcinoma, followed by adenocarcinoma.
How does advanced cervical carcinoma cause kidney failure?
It spreads into the parametria and compresses or encases the ureters, causing bilateral hydronephrosis.
Which HPV type is relatively more frequent in cervical adenocarcinoma and small cell carcinoma?
HPV 18.
Elsewhere in DurgiPedia
Connections
Microorganisms1
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Cervical Cancer (StatPearls (NCBI Bookshelf), 2026); Cervical Cancer Treatment (PDQ®)–Health Professional Version (National Cancer Institute, 2026); Cervical cancer mortality among young women in Latin America and the Caribbean: trend analysis from 1997 to 2030 (BMC public health, 2022).
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Representative model, for educational purposes only.