Diagnosis and treatment of cervical papillary squamous cell carcinoma with unknown depth of stromal invasion

To evaluate the diagnosis and treatment of papillary squamous cell carcinoma (PSCC) of the uterine cervix with unknown depth of stromal invasion.In a retrospective study, the diagnostic and treatment strategies after colposcopy-guided biopsy sampling were assessed among patients seen at a university hospital in Shanghai, China, in 2008-2015.Among 55 patients, 29 with clinically visible lesions underwent radical hysterectomy; the final pathologic diagnosis was invasive squamous cell carcinoma in all patients. Of these patients, eight had undergone loop electrosurgical excision procedure (LEEP) and two had undergone a second biopsy sampling before radical hysterectomy was performed. Of the 26 patients with no clinically visible lesions, 17 had cervical lesions as confirmed by medical imaging and 12 of these patients underwent LEEP. The pathologic examination showed lesions of varying severity but no cancer in situ. The remaining five patients underwent radical hysterectomy; one of these patients was found to have micro-invasive cancer.Patients with PSCC with unknown depth of stromal invasion and clinically visible lesions receive radical hysterectomy rather than undergoing a second biopsy sampling or LEEP. Less invasive surgery is recommended for patients with no clinically visible lesions.