Cervical cancer differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]
Overview
Cervical cancer must be differentiated from other diseases that cause abnormal vaginal bleeding, such as cervical polyp, cervical leiomyoma, invasion of the cervix from primary uterine malignancy, vaginal cancer, cervical lymphoma, metastases to cervix, and cervical ectopic pregnancy.
Cervical cancer differential diagnosis
- Cervical cancer must be differentiated from a mass involving the cervix, and causing abnormal vaginal bleeding:
- Cervical polyp
- Cervical leiomyoma
- Cervical lymphoma
- Cervical sarcoma
- Metastases to the cervix
- Cervical ectopic pregnancy
- Cervical polyp
- Cervicitis
- Cervical erosion ( Ectropion )
- IUD use
- Pelvic inflammatory disease
- Endometriosis
- Adenomyosis
- Postcoital bleeding
- Clear cell adenocarcinoma
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | ||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical exam | Lab Findings | Imaging | Histopathology | ||||||||||||||||||||||
| Abnormal vaginal bleeding | Abnormal vaginal dyscharge | Pelvic pain or pressure | Itching or burning of the vulva | Vaginal/vulvar sores or discoloration | Genitourinary/ Gastrointestinal symptoms | Abdominal pain | Fever | Swollen lymph nodes | Weight loss | Gynecological examinations | HPV | Pap smear | STI Panel | Coagulation studies | Imaging 1 | Imaging 2 | Imaging 3 | |||||||||
| Cervical cancer[1][2] |
|
+ | + | + | − |
|
+ |
+ | + | + | ||||||||||||||||
| Cervical polyp[3] |
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+ | _ | _ | _ | _ | _ | _ | _ | _ | ||||||||||||||||
| Cervical leiomyoma[4] |
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| Cervical lymphoma[5] |
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+ | + | + | + | |||||||||||||||||||||
| Cervical sarcoma[6] |
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| Cervical erosion(Ectropion)[7] |
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+ | ||||||||||||||||||||||||
| Cervicitis[8] |
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+ | + |
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| IUD use |
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| Pelvic inflammatory diseases | + | + |
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| Endometriosis |
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Pelvic pain/back pain |
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| Adnemyosis[9] |
|
+ | ||||||||||||||||||||||||
| Cervical ectopic pregnancy[10] | ||||||||||||||||||||||||||
| DES exposure (Clear cell adenocarcinoma)[11] |
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+ |
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| Paget's disease of vulva to cervix[12][13] |
|
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| Vaginal cancer[14] | Postcoital bleeding | |||||||||||||||||||||||||
| Nabothian cyst | ||||||||||||||||||||||||||
References
- ↑ Hippisley-Cox J, Coupland C (January 2013). "Symptoms and risk factors to identify women with suspected cancer in primary care: derivation and validation of an algorithm". Br J Gen Pract. 63 (606): e11–21. doi:10.3399/bjgp13X660733. PMC 3529288. PMID 23336450.
- ↑ Dunyo, Priscilla; Effah, Kofi; Udofia, Emilia Asuquo (2018). "Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study". BMC Public Health. 18 (1). doi:10.1186/s12889-018-6065-6. ISSN 1471-2458.
- ↑ Mitchell H (May 2004). "Vaginal discharge--causes, diagnosis, and treatment". BMJ. 328 (7451): 1306–8. doi:10.1136/bmj.328.7451.1306. PMC 420177. PMID 15166070.
- ↑ Al-Habib A, Elgamal EA, Aldhahri S, Alokaili R, AlShamrani R, Abobotain A, AlRaddadi K, Alkhalidi H (November 2016). "Large primary leiomyoma causing progressive cervical deformity". J Surg Case Rep. 2016 (11). doi:10.1093/jscr/rjw190. PMC 5159177. PMID 27887011.
- ↑ Grace A, O'Connell N, Byrne P, Prendiville W, O'Donnell R, Royston D, Walsh CB, Leader M, Kay E (1999). "Malignant lymphoma of the cervix. An unusual presentation and a rare disease". Eur. J. Gynaecol. Oncol. 20 (1): 26–8. PMID 10422676.
- ↑ Wright JD, Rosenblum K, Huettner PC, Mutch DG, Rader JS, Powell MA, Gibb RK (November 2005). "Cervical sarcomas: an analysis of incidence and outcome". Gynecol. Oncol. 99 (2): 348–51. doi:10.1016/j.ygyno.2005.06.021. PMID 16051326.
- ↑ Mitchell H (May 2004). "Vaginal discharge--causes, diagnosis, and treatment". BMJ. 328 (7451): 1306–8. doi:10.1136/bmj.328.7451.1306. PMC 420177. PMID 15166070.
- ↑ Mattson SK, Polk JP, Nyirjesy P (July 2016). "Chronic Cervicitis: Presenting Features and Response to Therapy". J Low Genit Tract Dis. 20 (3): e30–3. doi:10.1097/LGT.0000000000000225. PMID 27243142.
- ↑ Filip G, Balzano A, Cagnacci A (November 2018). "Histological evaluation of the prevalence of adenomyosis, myomas and of their concomitance". Minerva Ginecol. doi:10.23736/S0026-4784.18.04291-0. PMID 30486633.
- ↑ Mouhajer M, Obed S, Okpala AM (June 2017). "Cervical Ectopic Pregnancy in Resource Deprived Areas: A Rare and Difficult Diagnosis". Ghana Med J. 51 (2): 94–97. PMC 5611908. PMID 28955106.
- ↑ Tantitamit T, Hamontri S, Rangsiratanakul L (May 2017). "Clear cell adenocarcinoma of the cervix in second generation young women who are without maternal exposure to diethylstilbestrol: A case report". Gynecol Oncol Rep. 20: 34–36. doi:10.1016/j.gore.2017.02.008. PMC 5328756. PMID 28275694.
- ↑ van der Linden, M.; Meeuwis, K.A.P.; Bulten, J.; Bosse, T.; van Poelgeest, M.I.E.; de Hullu, J.A. (2016). "Paget disease of the vulva". Critical Reviews in Oncology/Hematology. 101: 60–74. doi:10.1016/j.critrevonc.2016.03.008. ISSN 1040-8428.
- ↑ Lloyd J, Evans DJ, Flanagan AM (July 1999). "Extension of extramammary Paget disease of the vulva to the cervix". J. Clin. Pathol. 52 (7): 538–40. PMC 501500. PMID 10605411.
- ↑ Tarney CM, Han J (2014). "Postcoital bleeding: a review on etiology, diagnosis, and management". Obstet Gynecol Int. 2014: 192087. doi:10.1155/2014/192087. PMC 4086375. PMID 25045355.