Presentation is loading. Please wait.

Presentation is loading. Please wait.

Tumors of Cervix.

Similar presentations

Presentation on theme: "Tumors of Cervix."— Presentation transcript:

1 Tumors of Cervix

2 BENIGN MALIGNANT Primary Secondary Adenoma Myoma Papilloma and angioma
Carcinoma Sarcoma Mesodermal mixed tumor Secondary From any source

3 Adenoma (Mucous Polyp)
Clinical Features Asymptomatic Vaginal discharge Vaginal bleeding Mass at the introitus Differential Diagnosis Carcinoma of the cervix Cervical ectopy Endometrial polyp Products of conception and blood clot Ectropion Cervical tags

4 Adenoma (Mucous Polyp)
Treatment Asymptomatic must be removed and examined by the histopathologist Adenoma may be avulsed easily without anaesthesia Base of the polyp should be cauterized to avoid recurrence Perform curettage

5 Myomas of Cervix Arise from body of uterus, rarely from cervix
Polypoidal Protrude through cervical canal Types Subserous Intramural submucous Myomas of Cervix

6 Myomas of Cervix Clinical Features Treatment Prone to trauma
Ulceration Infection Vaginal discharge Irregular vaginal bleeding Mass at the introitus Treatment Vagival myomectomy or hysterectomy

7 Papilloma and Angioma Clinical features Treatment Small papillomas
Single or multiple associated with vulva and vaginal papillomas Angioma forms superficial growth Treatment Surgical removal

8 Pre Malignant Conditions of Cervix

9 Cervical Intraepithelial Neoplasia (CIN) or Dysplasia
Spectrum of disordered growth and abnormal microscopic changes confined to epithelium May be Mild (CIN I) Moderate (CIN II) Severe or carcinoma in situ (CIN III) Spontaneous regression of mild and moderate types possible Severe dysplasia may be irreversible May progress into invasive carcinoma


11 Cervical Intraepithelial Neoplasia (CIN) or Dysplasia
CIN I (mild) Involves deeper 3rd of epithelium CIN II (moderate) Involves more than half thickness of epithelium CIN III (severe) Whole thickness of epithelium shows abnormal changes

12 Screening Normal cervix, transition zone Screening programme
Cervical smear Repeated every 3 y up to 60 y Normal cervix, transition zone





17 Invasive carcinoma of cervix, Pap smear
These cancer cells are very anaplastic and show marked variation in size. Note the enormous size of the tumor cells which can be appreciated in comparison with neutrophils present in the smear. anaplastic cancer cells show marked variation in size, in comparison with neutrophils

18 Treatment Cryocautry Electrocuatry Surgery Follow up Conization LEEP
Hysterectomy Follow up




22 Malignant Tumours of Cervix

23 Ca cervix One of the most common cancers in the world Incidence:
USA 10/ UK 15/ Peak incidence at 35 and 55

24 Etiology Number of partners Age of first coitus Grand multi parity
Social status Race and religion Circumcision Smoking Viruses herpes simplex type 2 / human papulama virus type 16 & 18 Atypical squamous metaplasia



27 Pathology SQ cell carcinoma 90 % Adeno 5% Mixed 5% Gross Polypoidal
Ulcerative Infiltrative

28 Squamous cell carcinoma cervix
Tumour extends to anterior and posterior lips, appears granular and hemorrhagic, cervix surrounding by narrow vaginal cuff Squamous cell carcinoma of cervix The tumor extends to the anterior and posterior lips and appears somewhat granular and hemorrhagic. The cervix is surrounding by a narrow vaginal cuff.

29 Squamous cell carcinoma in-situ of cervix
                                                             Normal epithelium Squamous cell carcinoma in-situ of cervix To the right is normal squamous epithelium with its basal cell layer and orderly maturation upwards. The left side shows carcinoma in-situ characterized by lack of maturation, altered cell polarity, nuclear pleomorphism and increased nuclear / cytoplasmic ratio. As is characteristic of carcinoma in-situ, the neoplastic cells are confined to the epithelial layer and have not invaded through the epithelial basement membrane, under which, the submucosal stroma contains chronic inflammatory cells. lack of maturation, altered cell polarity, nuclear pleomorphism and increased nuclear / cytoplasmic ratio, confined to the epithelial layer, epithelial basement membrane not invaded, submucosal stroma contains chronic inflammatory cells

30 Spread Direct Lymphatic Blood born


32 Diagnosis History Asymtpomatic
Irregular vaginal bleeding IMB, PCB, PMB Pain Vaginal discharge Examination Normal cervix Hard cervix Ulcer Growth

33 Carcinoma Cervix

34 Diagnosis Cytology Schiller test Colposcopy Biopsy of cervix
Punch biopsy Wedge biopsy Ring biopsy Cone biobsy


36 Treatment Assessment Radiotheraphy
Surgery young, pelvic sepsis, UV prolapse, fibroid, ovarian tumor, recurrence, pregnancy Combined

37 Case History Age 36, mass at endocervical os which thickens the barrel of the cervix and fixes the cervix to the surrounding soft tissue Pap smear shows

38 Case History biopsy showed invasive nests of abnormal squamous epithelium extending under the surface mucosa, extending all the way through the cervical wall and out into the surrounding paracervical soft tissue

39 Case History The patient underwent a hysterectomy. The gross specimen shows thickened area representing the cervix. Tumour has extended through the wall. cervix was fixed to the soft tissues of the paracervical area

40 Thank You

Download ppt "Tumors of Cervix."

Similar presentations

Ads by Google