The influence of endometriosis on the staging of cervical cancer

Pelvic endometriosis often presents as nodularity of the uterosacral and broad ligaments. Therefore, the presence of unrecognized pelvic endometriosis in cervical cancer patients can masquerade as parametrial spread of tumor, preventing correct assessment of stage of disease. A review of three cases in which these disease processes coexisted demonstrates that endometriosis can easily be mistaken for tumor extension on pelvic examination, computed tomography, and even gross inspection at laparotomy, resulting in incorrect staging and inappropriate management decisions. Because clinical staging often is inaccurate in cervical cancer patients with a history of endometriosis, pre-treatment operative assessment should be considered and frozen sections are recommended to assist with intraoperative management whenever the diagnosis of endometriosis could be entertained.