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A Case of Parametrial Lymph Node Involvement in Stage IA2 Squamous Cell Carcinoma of the Cervix Treated With Radical Hysterectomy and a Review of the Literature: A Case Report

Billingsley, Caroline C. MD1; Kohler, Matthew F. MD2; Creasman, William T. MD2; Madory, James E. DO3; Young, Jennifer L. MD2

Journal of Lower Genital Tract Disease: April 2012 - Volume 16 - Issue 2 - p 145–148
doi: 10.1097/LGT.0b013e3182350490
Case Reports

Cervical cancer classified as stage IA2 and IB1 according to the International Federation of Gynecology and Obstetrics has historically been treated with radical hysterectomy and bilateral lymph node dissection, but recent recommendations suggest more conservative treatment modalities. We report a woman with stage IA2 cervical cancer at low risk for parametrial spread including no lymphovascular space invasion, clear conization margins, and tumor size less than 2 cm, who underwent radical hysterectomy and was found to have a single positive metastatic parametrial lymph node. This case report is an important reminder that parametrial involvement occurs in low-risk early-stage cervical cancers.

It is imperative that patients are informed of the possibility of parametrial involvement and possible sequelae of suboptimal management when parametrectomy is omitted in radical hysterectomies.

1Department of Obstetrics and Gynecology, 2Division of Gynecology Oncology, Departments of Obstetrics and Gynecology and 3Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC

Reprint requests to: Caroline C. Billingsley, MD, 96 Jonathan Lucas St, CSB Suite 643, MSC 619, Charleston, SC 29425. E-mail:

The authors have no conflict of interest to disclosure.

©2012The American Society for Colposcopy and Cervical Pathology