A case of bilateral pelvic lymph node involvement in stage 1a1 squamous cell carcinoma of cervix and a review of the literature.

Stage1a1 cervical cancer has been established to define a subset of the disease in patients who may safely be managed more conservatively and who have an excellent prognosis. Recently, however, a number of stage 1a1 cases with lymph node metastasis have been reported. Some of these cases had positive lymphovascular space invasion (LVSI), which some studies have identified as a negative prognostic factor. There is still, however, disagreement between the International Federation of Gynecology and Obstetrics (FIGO) and the Society of Gynecologic Oncologists (SGO) regarding whether LVSI may be used as a staging criterion. We report a 36-year-old patient with stage 1a1 cervical cancer who was diagnosed with multiple pelvic and parametrial lymph node metastases. Histopathology showed extensive LVSI. While stage 1a1 cases may still be managed conservatively, physicians must consider the possibility of lymph node metastasis, particularly in patients with positive LVSI, and counsel patients accordingly.