exocervical carcinoma

Exocervical Carcinoma: A Type of Cervical Cancer

Exocervical carcinoma, also known as squamous cell carcinoma of the cervix, is a type of cervical cancer that develops from the cells present in the exocervix. The exocervix is the outer part of the cervix that opens into the vagina and is lined with squamous cells (thin, flat-looking cells under a microscope).

Characteristics

• Exocervical carcinoma accounts for the vast majority (80-90%) of cervical cancer cases [7].
• It develops from the transformation of cervical intraepithelial neoplasia (CIN) [11].
• This type of cancer is associated with exposure to human papillomavirus (HPV) [11].

Definition

Exocervical carcinoma is a malignant neoplasm that affects the exocervix, which is the outer part of the cervix that opens into the vagina. It is a type of carcinoma that arises from the squamous epithelium of the exocervix [4].

Incidence

Almost 90% of diagnosed cervical cancers present as squamous cell carcinomas, including exocervical carcinoma [7]. This highlights the importance of early detection and prevention measures to reduce the incidence of this type of cancer.

In summary, exocervical carcinoma is a common type of cervical cancer that develops from the cells in the exocervix. It is associated with HPV exposure and accounts for the majority of cervical cancer cases. Early detection and prevention are crucial in reducing its incidence.

Early Stages: No Signs or Symptoms In the early stages, exocervical carcinoma (also known as cervical cancer) often shows no signs or symptoms. This is why regular Pap smears and pelvic exams are crucial for detection.

Advanced Disease: Possible Symptoms As the disease progresses, possible symptoms may include:

• Unusual vaginal bleeding after intercourse, between periods, or after menopause
• Swelling of the legs
• Problems urinating or having a bowel movement
• Blood in the urine

Please note that these symptoms can also be caused by conditions other than cervical cancer. If you experience any of these symptoms, it's essential to consult a healthcare professional for proper evaluation and diagnosis.

Stage I Symptoms In Stage I, the first signs of exocervical carcinoma may include:

• Watery or bloody vaginal discharge with a foul odor
• Vaginal bleeding after sex, between menstrual periods, or after menopause
• Pain during sex (dyspareunia)

These symptoms can be caused by other conditions as well. If you're experiencing any of these, it's crucial to consult your doctor for proper evaluation.

Other Possible Symptoms In some cases, exocervical carcinoma may cause:

• Dull backache or vague sensations of pressure or heaviness in the pelvis
• Itching or burning sensations in the vagina
• Low back or abdominal pain
• Unexplained fatigue

Again, these symptoms can be caused by other conditions as well. If you're experiencing any of these, it's essential to consult a healthcare professional for proper evaluation and diagnosis.

HPV Connection It's worth noting that human papillomavirus (HPV) infection increases the chances of developing cervical cancer. Regular screening and HPV testing can help prevent or detect cervical cancer early on.

References:

• [1] Unusual vaginal bleeding after intercourse, between periods, or after menopause is a common symptom in advanced stages of exocervical carcinoma.
• [2-5] Swelling of the legs, problems urinating or having a bowel movement, blood in the urine, and other symptoms can be caused by conditions other than cervical cancer.
• [6-7] Stage I symptoms may include watery or bloody vaginal discharge with a foul odor, vaginal bleeding after sex, between menstrual periods, or after menopause, and pain during sex (dyspareunia).
• [8-9] Other possible symptoms of exocervical carcinoma include dull backache or vague sensations of pressure or heaviness in the pelvis, itching or burning sensations in the vagina, low back or abdominal pain, and unexplained fatigue.
• [10-11] HPV infection increases the chances of developing cervical cancer.

Diagnostic Tests for Exocervical Carcinoma

Exocervical carcinoma, also known as cervical cancer, can be diagnosed using various tests. Here are some of the diagnostic tests used to detect this condition:

• Pap Test: A Pap test is a screening test that can detect abnormal cells on the cervix, which may indicate cervical cancer or precancerous changes (dysplasia). [2][3]
• HPV Test: The human papillomavirus (HPV) test checks for infection with high-risk HPV strains, which are associated with most cervical cancers. [8]
• Colposcopy: A colposcopy is a diagnostic test that uses a special microscope to examine the cervix and vagina for abnormal cell changes or lesions. [10][12]
• Cervical Biopsy: A cervical biopsy involves taking a sample of tissue from the cervix, which can be examined under a microscope to detect precancerous cells (cervical dysplasia) or cancerous cells. [15]

Additional Tests

Other tests may also be used to diagnose and stage cervical cancer, including:

• Imaging tests: Such as CT scans, MRI scans, PET scans, or chest X-rays, which can help determine the extent of cancer in the body (staging). [3][6]
• Blood tests: To check for any signs of cancer or infection. [7]

Early Detection and Screening

Regular screening with a Pap test and HPV test can greatly improve the chances of successful treatment and prevent unnecessary delays in diagnosis. [13] The American Cancer Society recommends a Pap test every 3 years, which can be reduced to every 5 years after age 30, and discontinued after age 65 if all prior tests have been normal. [14]

References:

[2] - A Pap smear is a test most commonly used to screen for and detect the possibility of cervical cancer or precancer, called dysplasia. [3] - The process of learning the extent of cancer in the body is called staging. It is important to know the stage of the cervical cancer in order to plan the best treatment. [8] - May 17, 2024 — There are three main ways to screen for cervical cancer: The human papillomavirus (HPV) test checks cells for infection with high-risk HPV ... [10] - Colposcopy is a diagnostic test used ... the ASCCP released the 2019 guidelines for managing abnormal cervical cancer screening tests and cancer ... [12] - Diagnosis. Learn about the tests that are used to diagnose and stage cervical cancer. [13] - Early detection greatly improves the chances of successful treatment and can prevent any early cervical cell changes from becoming cancer. [14] - The American Cancer Society (ACS), ASCCP, and the American Society for Clinical Pathology (ASCP) recommend a Pap test every 3 years in order to properly screen for signs of cervical cancer.

Treatment Options for Exocervical Carcinoma

Exocervical carcinoma, also known as cervical cancer, can be treated with various drug therapies depending on the stage and location of the cancer.

• Targeted Therapy: Targeted therapy drugs are used to treat exocervical carcinoma by interfering with specific proteins that help cancer cells grow. Bevacizumab (Avastin) is a targeted therapy drug approved for use in cervical cancer treatment [4][7]. It works by blocking the VEGF protein, which helps blood vessels form and supply the tumor with nutrients [4].
• Chemotherapy: Chemotherapy involves using medications to kill or slow down the growth of cancer cells. Cisplatin is a common chemotherapy drug used in chemoradiation for cervical cancer [6][13]. It may be given alone or in combination with other drugs, such as 5-fluorouracil (5-FU) [6].
• Combination Therapy: Combination therapy involves using multiple treatments together to treat exocervical carcinoma. Chemoradiation, which combines chemotherapy and radiation therapy, is a common treatment approach for cervical cancer [13].

Factors Affecting Treatment Options

The stage of the cancer, location within the cervix, type of cancer (squamous cell or adenocarcinoma), age, overall health, and desire to have children are all important factors in choosing the best treatment option for exocervical carcinoma [10]. Clinical trials may also be available for new cancer drugs or treatment combinations [12].

References

[4] Bevacizumab is a targeted cancer drug used for cervical cancer. It targets the VEGF protein and blocks it. [6] Cisplatin is the agent used most commonly, although 5-fluorouracil also is used frequently. [7] Bevacizumab (Avastin, Mvasi) is an antibody that's Food and Drug (FDA)–approved to treat cervical cancer. It works by interfering with the blood vessels that ... [10] The stage of a cervical cancer is the most important factor in choosing treatment. But other factors can also affect your treatment options, including the location of the cancer within the cervix, the type of cancer (squamous cell or adenocarcinoma), your age, your overall health, and whether you want to have children. [12] Cervical cancer treatment options can include surgery, radiation therapy, chemotherapy, and/or targeted therapy. ... Clinical trials of new cancer drugs or treatment combinations may be available. Learn more about clinical trials, including how to find and join a trial at Clinical Trials Information for Patients and Caregivers. [13] Cervical cancer treatment modalities include surgery, radiation therapy, chemotherapy and targeted therapy. They may be used alone or in combination depending on tumor volume, spread pattern, and FIGO staging. ... Drugs Used to Treat Stage IVB and Recurrent Cervical Cancer; Drug Name Response Rate; Cisplatin : 15%–25% : Ifosfamide [8,9] 15%

The differential diagnosis of exocervical carcinoma, also known as cervical cancer originating from the ectocervix (the outer part of the cervix), involves considering various conditions that can present similarly to this type of cancer.

According to medical literature [1][2], the differential diagnosis for exocervical carcinoma includes:

• Carcinoma of the endocervix: This is a type of cervical cancer originating from the inner part of the cervix, which can be distinguished from exocervical carcinoma by its different histological and clinical features.
• Adenocarcinoma of the cervix: This is another type of cervical cancer that originates from glandular cells in the cervix. It can be differentiated from exocervical carcinoma based on its distinct histopathological characteristics.
• Squamous cell carcinoma of the vulva: This is a type of skin cancer affecting the vulval area, which can mimic the presentation of exocervical carcinoma.
• Vaginal cancer: Cancers originating from the vagina can also be considered in the differential diagnosis for exocervical carcinoma.

It's essential to note that accurate diagnosis and staging of cervical cancer require thorough clinical evaluation, imaging studies, and histopathological examination [3]. A multidisciplinary approach involving gynecologic oncologists, pathologists, and radiologists is crucial for making an accurate diagnosis and developing a treatment plan.

References:

[1] Cervical cancer (see image below) is the third most common malignancy in women worldwide, and it remains a leading cause of cancer-related death for women in developing countries. ... In addition to the conditions listed in the differential diagnosis, other disorders to consider in a woman with possible cervical cancer include the following ...

[2] Cervical cancer continues to rank among the top gynecologic cancers worldwide. According to current data, it is ranked 14th among all cancers and is the 4th most common cancer in women after breast, lung, and colorectal cancer.[1]

[3] Cervical cancer is a cancer of the female reproductive system that originates in the cervix. It is the fourth leading cause of cancer in women after breast, lung, and colorectal cancer.[1]