Difficulties in diagnosing unusual spread of cervical carcinoma

A case involving unusual spread of cervical carcinoma in a 66-year-old white woman who remained relatively asymptomatic for 26 years after radiation therapy for stage III or IV squamous cell carcinoma is presented. Despite an extensive clinical work-up, diagnosis was not made until a large retroperitoneal tumor mass was discovered at necropsy. The subtle clues of occult malignancy are discussed and a mechanism for the unusual spread of the cervical carcinoma is presented.