Cancer of the cervix uteri.

The cervix is the lower aspect of the uterus. It is roughly cylindrical in shape, projects through the superior-anterior vaginal wall, and communicates with the vagina through the endocervical canal, which terminates in the external os located at the top of the vagina. Cancer of the cervix may originate from the mucosa of the surface of the cervix or from within the canal. Carcinoma of the uterine cervix grows locally and may extend in continuity to the uterus and paracervical tissues, and pelvic organs. Cervical cancer may spread to regional lymph nodes, and only later metastasize hematogenously to distant structures. The cervix is drained into the following first echelon nodal stations: parametrial, internal iliac (obturator–hypogastric), external iliac, and presacral, followed by drainage to the common iliac nodes. From the common iliac nodes, lymph drainage goes to the paraaortic nodes. The most common sites of distant spread include the para-aortic, mediastinal and supraclavicular nodes, the lungs, liver, and skeleton.