The finding of invasive cervical carcinoma in the uterus of patients who had undergone hysterectomy occurs for a variety of reasons; Failure to detect occult invasion such as emergency hysterectomy, incorrect Pap smear, and failure of even
extensive
evaluation. This unexpected cervical carcinoma could be avoided by careful adherence to well-established guidelines for cervical cancer detection; Performance of a yearly Papanicolaou smear, evaluation of an abnormal Papanicolaou smear or
cervical
biopsy by colposcopy and endocervical curettage to determine the extent of disease, and conization when colposcopy is inadequate, when the cervical curettings reveal dysplasia, or when any degree of invasive disease is suspected. In this clinical
situation, patients present a difficult management problem. Once the hysterectomy has been performed, it is no. longer possible to stage the patient. In the immediate postoperative period it may be difficult to distinguish residual pelvic tumor
from
inflammatory reaction. While treatment for all patients must be individualized, a radical reoperation should be considered a safe and efficacious alternative to pelvic radiation for patients who are deemed to require additional therapy. The
general
feeling has been prevalent that such patients have a poor prognosis regardless of what further therapy is attempted. The authers experienced four cases of unexpected cervical carcinoma, and report our experience with brief review of literature.
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