Cervical Masses

Synonyms/Description

None

Etiology

Cervical cancer accounts for the majority of cervical malignancies and is second to breast cancer in incidence worldwide. Approximately 85% to 95% of cervical cancers are squamous cell carcinomas and develop at the squamous-columnar junction.

Adenocarcinomas represent only 5% of cervical cancers and arise from glandular cells found in the endocervical canal. Squamous cell lesions of the cervix are typically detected early using conventional cytologic screening methods (Pap test) because they are easy to sample. The majority of endocervical glands are deep within the cervical canal, so detection usually occurs at more advanced stages of disease; hence they have a poorer prognosis than squamous cell cancers. The survival for stages I, II, and III cervical adenocarcinoma is 60%, 47%, and 8% compared with 90%, 62%, and 36% for squamous cell carcinoma.

Non-Hodgkin’s lymphoma of the cervix is rare, accounting for 1% of all extranodal lymphomas. Clinically it may present as a large lobular vascular solid mass of the cervix. Metastatic disease, such as melanoma and breast, lung, and ovarian cancers, may also involve the cervix.

Malignant mixed Müllerian tumors and leiomyosarcomas occur more frequently in the uterine corpus, but may arise in the cervix in rare cases. Embryonal rhabdomyosarcomas typically occur in the pediatric age group.

Benign masses of the cervix include fibroids and polyps, which are similar in origin and appearance to their counterparts in the uterine corpus. Nabothian cysts are also commonly seen.