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Superficially Invasive Squamous Cell Carcinoma of the Uterine Cervix: The Assessment of Key Parameters

Lytwyn, Alice MD*; Zaino, Richard MD; Colgan, Terence J. MD; Otis, Christopher MD§

doi: 10.1097/PCR.0b013e3182990fd1
Case Reviews

A variety of terms have been used over the years to define a set of early invasive squamous carcinomas of the uterine cervix that can be treated by local excision only. The Lower Anogenital Squamous Terminology consensus group has recommended that the term “superficially invasive squamous cell carcinoma” (SISCCA) be used for any genital invasive squamous carcinoma that can be managed by local excision only. The definition of SISCCA varies by genital site. A diagnosis of SISCCA of the uterine cervix requires that the invasive lesion was not visualized, has been completely excised, has a depth of invasion no more than 3 mm, and has a horizontal extent of no more than 7 mm. Lymphovascular invasion may or may not be present and should be noted. Superficially invasive squamous cell carcinoma of the uterine cervix is synonymous with an International Federation of Gynecology and Obstetrics stage IA1 carcinoma. This review addresses morphologic challenges that can be seen in the diagnosis of SISCCA including the identification of early invasion, measurements of depth and horizontal extent, and the assessment of circumferential involvement and margin status.

From the *Department of Pathology, Juravinski Hospital, and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; †Penn State Hershey Anatomic Pathology, Hershey, PA; ‡Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Canada; and §Baystate Medical Center (Tufts University School of Medicine), Springfield, MA.

Reprints: Terence J. Colgan, MD, Department of Pathology and Laboratory Medicine, Room 6-502-3, Mount Sinai Hospital, 600 University Ave, Toronto, Canada M5G 1X5. E-mail:

The authors have no funding or conflicts to declare.

© 2013 by Lippincott Williams & Wilkins.