Mikael Häggström: Started

2022-12-22T00:32:45Z

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==Microscopic evaluation==
Infiltration as irregular anastomosing nests or single cells.<ref>{{cite web|url=https://www.pathologyoutlines.com/topic/cervixscc.html|title=Cervix - Squamous cell carcinoma and variants|website=Pathology Outlines|author=Author: Gulisa Turashvili, M.D., Ph.D.}} Last author update: 24 September 2020. Last staff update: 13 December 2022</ref> In contrast to tangentially cut projections of glands involved by HSIL, the invasive nests of tumor cells are irregular and accompanied by a distinct stromal reaction of edema and chronic inflammatory cells.
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File:Histopathology of squamous cell carcinoma of the cervix.png|'''Invasive SCC of the cervix'''
File:Invasive Squamous Carcinoma of the Cervix. Cold Knife Cone (6076190079).jpg|'''Invasive SCC of the cervix'''<ref group=image>[https://commons.wikimedia.org/wiki/File:Invasive_Squamous_Carcinoma_of_the_Cervix._Cold_Knife_Cone_(6076190079).jpg Invasive Squamous Carcinoma of the Cervix. Cold Knife Cone (6076190079).jpg] by Ed Uthman, MD. {{CC-BY 2.0 inline}}</ref>
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==Staging==
As per AJCC 9:<ref name="pmid33784415">{{cite journal| author=Olawaiye AB, Baker TP, Washington MK, Mutch DG| title=The new (Version 9) American Joint Committee on Cancer tumor, node, metastasis staging for cervical cancer. | journal=CA Cancer J Clin | year= 2021 | volume= 71 | issue= 4 | pages= 287-298 | pmid=33784415 | doi=10.3322/caac.21663 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33784415 }} </ref>
{| class="wikitable"
|-
! T CATEGORY
! FIGO STAGE
! T CRITERIA
|-
| TX
| Primary tumor cannot be assessed
|
|-
| T0
| No evidence of primary tumor
|
|-
| T1
| I
| Carcinoma is strictly confined to the cervix (extension to the corpus should be disregarded)
|-
| T1a
| IA
| Invasive carcinoma that can be diagnosed only by microscopy with maximum depth of invasion ≤5 mm
|-
| T1a1
| IA1
| Measured stromal invasion ≤3 mm in depth
|-
| T1a2
| IA2
| Measured stromal invasion >3 mm and ≤5 mm in depth
|-
| T1b
| IB
| Invasive carcinoma with measured deepest invasion >5 mm (greater than stage IA); lesion limited to the cervix uteri with size measured by maximum tumor diameter; note: the involvement of vascular/lymphatic spaces should not change the staging, and the lateral extent of the lesion is no longer considered
|-
| T1b1
| IB1
| Invasive carcinoma >5 mm depth of stromal invasion and ≤2 cm in greatest dimension
|-
| T1b2
| IB2
| Invasive carcinoma >2 cm and ≤4 cm in greatest dimension
|-
| T1b3
| IB3
| Invasive carcinoma >4 cm in greatest dimension
|-
| T2
| II
| Carcinoma invades beyond the uterus but has not extended onto the lower one-third of the vagina or to the pelvic wall
|-
| T2a
| IIA
| Involvement limited to the upper two-thirds of the vagina without parametrial invasion
|-
| T2a1
| IIA1
| Invasive carcinoma ≤4 cm in greatest dimension
|-
| T2a2
| IIA2
| Invasive carcinoma >4 cm in greatest dimension
|-
| T2b
| IIB
| With parametrial invasion but not up to the pelvic wall
|-
| T3
| III
| Carcinoma involves the lower one-third of the vagina and/or extends to the pelvic wall and/or causes hydronephrosis or nonfunctioning kidney; note: the pelvic wall is defined as the muscle, fascia, neurovascular structures, and skeletal portions of the bony pelvis; cases with no cancer-free space between the tumor and pelvic wall by rectal examination are FIGO stage III
|-
| T3a
| IIIA
| Carcinoma involves the lower one-third of the vagina, with no extension to the pelvic wall
|-
| T3b
| IIIB
| Extension to the pelvic wall and/or hydronephrosis or nonfunctioning kidney (unless known to be due to another cause)
|-
| T4
| IVA
| Carcinoma has involved (biopsy-proven) the mucosa of the bladder or rectum or has spread to adjacent organs (bullous edema, as such, does not permit a case to be assigned to stage IVA)
|}

===Microscopy report===
Example:
{|class="wikitable"
| Cervix, uterus, bilateral tubes, ovaries and parametria,<br>hysterectomy and bilateral salpingo-oophorectomy:
*Residual squamous cell carcinoma on anterior cervix, 3 mm in greatest dimension, with up to 2 mm invasion, with associated biopsy site changes, and high-grade squamous intraepithelial lesion (CIN III).
*Inactive endometrium

SYNOPTIC REPORT:<br>Based on Hysterectomy (current specimen) and previous cone biopsy:
*Procedure: Cone (previous procedure) and hysterectomy with bilateral salpingo-oophorectomy
*Tumor site: Anterior cervix
*Histologic type: Squamous cell carcinoma, HPV-associated
*Histologic grade: G2, moderately differentiated (based on current hysterectomy and previous cone biopsy
*Tumor size: Estimated tumor size is 2.6 cm in greatest dimension (based on previous cone biopsy)
*Depth of stromal invasion: 7 mm (based on previous cone biopsy)
*Lymphovascular invasion: Present (based on previous cone biopsy)
*Margin(s): Negative for invasive carcinoma
*Additional Findings:
:*High-grade squamous intraepithelial lesion (CIN 3)
:*Previous biopsy site changes
*p16 Immunohistochemistry: Positive (based on the previous cone biopsy)
*Pathologic stage: pT1b2, Invasive carcinoma greater than 2 cm and less than or equal to 4 cm in greatest dimension (based on current specimen and previous cone biopsy)
* FIGO Stage: IB2
|}
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Invasive squamous cell carcinoma of the cervix - Revision history

Mikael Häggström: Started