1. Cervical Cancer Keith Unger 2/24/06

2. Clinical History 47 yo F with vaginal bleeding and pelvic pain On exam, large cervical mass with parametrial involvement Biopsy performed. Pathology revealed moderately differentiated squamous cell carcinoma

4. FIGO Staging of Cervical Ca Stage I IA- Microscopic invasion limited to stroma with a maximum depth of 5 mm and no wider than 7 mm IB- Confined to cervix, but larger than than IA Stage II IIA- Involvement of Upper 2/3 of vagina IIB- Parametrial Involvement but not sidewall Stage III Extension to the Pelvic Sidewall or Hydronephrosis Stage IV Involvement of Bladder/Rectum or Distant Metstatic Disease

5. Lymphatics Predictable Lymph Node Spread in Cervical Ca Paracervical LNs → External Iliacs LNs → Common Iliac LNs→ Periaortic LNs

6. 1.4 cm Left External Iliac Lymph Node 0.9 cm Left Paraaortic Lymph Node