A 28-year-old nulligravid woman undergoes radical hysterectomy for a 1.8 cm squamous cell carcinoma of the cervix with no lymphovascular space invasion. She wishes to retain hormonal function. Which statement best justifies ovarian preservation or transposition in her case?
- A Ovarian metastasis in cervical squamous cell carcinoma occurs in under 2 percent, unlike adenocarcinoma where it approaches 10 percent ✓
- B Squamous cell carcinoma requires oestrogen for growth, so oophorectomy causes explosive recurrence
- C Ovarian preservation improves survival specifically for adenocarcinoma histology
- D Transposed ovaries eliminate the need for any follow-up imaging in irradiated fields
Correct answer: A. Ovarian metastasis in cervical squamous cell carcinoma occurs in under 2 percent, unlike adenocarcinoma where it approaches 10 percent
Explanation
Ovarian spread from cervical squamous carcinoma is rare, quoted around 0.5 to 2 percent, so preserving or transposing ovaries is acceptable in young women with early-stage squamous tumours and no high-risk features. Adenocarcinoma carries a substantially higher ovarian metastasis rate of roughly 5 to 10 percent, making preservation contentious in that histology. Transposed ovaries still carry a risk of dysfunction after pelvic radiotherapy and require surveillance.
Reference: Novak's Gynecology, 16th ed.
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Written and medically reviewed by the StethoPrep medical team.