[Microcarcinoma of the cervix uteri (author's transl)]

Microcarcinoma in the true sense of the word must be distinguished from so-called early stromal invasion. A clear diagnosis must be based on the histological investigation of an adequate biopsy specimen which encompasses the entire changes and enalbes tumour measurement in all three dimensions. With increasing experience it was recognized that the mortality due to microcarcinoma was very low even when limited surgery was performed. When only clearly defined cases were considered, the mortality was nill in early invasion and merely 1.2% in microcarcinomas with a fictitious volume of up to 500 cmm. Both morphological signs of regression of invasive buds and recent knowledge of tumour immunology point to the effectiveness of immunological defence reactions, which are directly related to the tumour mass. A correctly diagnosed microcarcinoma represents a still-localized disease process unless other speical criteria such as lymphatic invasion point to the possibility of discontinuous spread. The method of treatment must be chosen between the extremes: When the danger of metastasis may be neglected local excision of the total diseased area will suffice; in the opposite case, radical operation with lymphadenectomy is indicated. Limited treatment of a microcarcinoma is only justified following clear definition of the lesion based on adequately removed and histologically accurately analyzed biopsy material.