Occult invasive cervical cancer, FIGO III stage, with a negative Pap smear test – clinical presentation and brief review of the literature

Invasive cervical cancer and negative pap smear


  • Paolo Meloni Department of Obstetrics and Gynecology, Imperia Hospital, ASL1 Imperiese, Italy https://orcid.org/0009-0000-7725-4576
  • Terenzia Simari Ambulatorio Specialistico Ginecologia Ostetricia, ASL1 Imperiese, Italy
  • Ilaria Cassella Radiology Service, Imperia Hospital, ASL1 Imperiese
  • Lai Roberta Radiology Service, Imperia Hospital, ASL1 Imperiese, Italy
  • Rodolfo Brizio Human Pathology Service, Imperia Hospital, ASL1 Imperiese
  • Roberto Conturso Obstetrics and Gynecology Service, Sant’Anna Clinic https://orcid.org/0009-0000-8980-0212
  • Davide Russo Human Patholohy Service, University Hospital, Foggia https://orcid.org/0000-0002-3159-6957
  • Edward Araujo Júnior Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP)
  • Gabriele Tonni Department of Obstetrics and Gynecology, and Researcher, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), ASL Reggio Emilia,

Klíčová slova:

Occult carcinoma of the cervix, FIGO classification, computed tomography, magnetic resonance imaging, pathology


Occult cervical cancer is rare and is diagnosed incidentally after simple hysterectomy. The staging on histological examination is usually International Federation of Gynecology and Obstetrics (FIGO) stage I, rarely higher with negative preoperative diagnostic tests such as Pap smear. The clinical case in question is a rare case of cervical carcinoma diagnosed at the time of hysterectomy with a negative exo-endocervical Pap smear, diagnostic tests including transvaginal ultrasound, abdominal magnetic resonance imaging and abdominal computed tomography with a diagnosis of degenerating myoma or suspected sarcoma. In the operating theatre the surgical radicality was modified and the operation was completed with removal of the parameters, vaginal collar and bilateral pelvic lymphadenectomy. The final histological examination indicated FIGO stage III, for which the patient underwent radiotherapy and chemotherapy.