[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Female genital tract](https://durgical.com/en/general-pathology/areas/female-genital/) › Invasive cervical carcinoma # 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. Updated Nov 12, 2026 ## Key points - Squamous cell carcinoma: the commonest type, from HSIL; peak incidence in the fourth and fifth decades. - Adenocarcinoma: from adenocarcinoma in situ; relatively more HPV 18; harder to detect on cytology; a minority (such as gastric type) are HPV-independent. - Small cell (high-grade neuroendocrine) carcinoma: rare, HPV 18 associated, aggressive with early spread. - Spread: parametria and pelvic side wall, vagina, bladder, rectum; paracervical, obturator, iliac then para-aortic nodes; distant metastases late. - Ureteral compression causes hydronephrosis and uremia; FIGO stage is the main prognostic factor. ## 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. ## Memory aid Cervical cancer grows sideways: it walks into the parametria, steps on the ureters and the kidneys pay the price. ## 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. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/invasive-cervical-carcinoma/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [Cervix and vagina: the transformation zone](https://durgical.com/en/histology/cervix-and-vagina-the-transformation-zone/) ## Connections ## Related 8 - [HPV and cervical carcinogenesis](https://durgical.com/en/general-pathology/hpv-and-cervical-carcinogenesis/) - [Cervical squamous intraepithelial lesions (LSIL, HSIL)](https://durgical.com/en/general-pathology/cervical-squamous-intraepithelial-lesions/) - [Cervical cancer screening and prevention](https://durgical.com/en/general-pathology/cervical-cancer-screening-and-prevention/) - [Diseases of the vagina](https://durgical.com/en/general-pathology/diseases-of-the-vagina/) - [Urinary tract obstruction and hydronephrosis](https://durgical.com/en/general-pathology/urinary-tract-obstruction-and-hydronephrosis/) - [Grading and staging: what TNM means](https://durgical.com/en/general-pathology/grading-and-staging-what-tnm-means/) - [Pathways of spread and the usual metastatic sites](https://durgical.com/en/general-pathology/pathways-of-spread-and-the-usual-metastatic-sites/) - [Invasion and metastasis: the metastatic cascade, step by step](https://durgical.com/en/general-pathology/invasion-and-metastasis-the-metastatic-cascade-step-by-step/) ## Related conditions 5 - [Cervical cancer](https://durgical.com/en/conditions/cervical-cancer/) - [Hydronephrosis and obstructive uropathy](https://durgical.com/en/conditions/hydronephrosis-and-obstructive-uropathy/) - [Chronic kidney disease](https://durgical.com/en/conditions/chronic-kidney-disease/) - [Human papillomavirus (HPV) infection](https://durgical.com/en/conditions/human-papillomavirus-infection/) - [Obstetric fistula (vesicovaginal and rectovaginal)](https://durgical.com/en/conditions/obstetric-fistula/) ## Microorganisms 1 - [Human papillomavirus](https://durgical.com/en/microbiology/human-papillomavirus/) [← All of general pathology](https://durgical.com/en/general-pathology/) 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](https://www.ncbi.nlm.nih.gov/books/NBK431093/) (StatPearls (NCBI Bookshelf), 2026); [Cervical Cancer Treatment (PDQ®)–Health Professional Version](https://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq) (National Cancer Institute, 2026); [Cervical cancer mortality among young women in Latin America and the Caribbean: trend analysis from 1997 to 2030](https://europepmc.org/article/PMC/PMC8761303/) (BMC public health, 2022). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/invasive-cervical-carcinoma/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/invasive-cervical-carcinoma/