The human papillomavirus (HPV) test has recently been added to the Pap smear as a screening modality for cervical cancer in some countries. 10 In these patients, cytological examination results are often negative. However, this method is inadequate for women with rare cervical cancers, such as small-cell carcinoma of the cervix, that do not invade the surface epithelium of the cervix but diffusely infiltrate cervical stroma. Pap smears are used for primary prevention to screen for pre-invasive lesions, enabling early diagnosis and treatment that can lead to significantly lower mortality rates. Meanwhile, late clinical manifestations include irregular vaginal bleeding of varying amounts with corresponding symptoms of distant metastasis. 9 Cervical cancer primarily presents with hemorrhage in the early disease stage. Other rare primary tumors include clear-cell carcinoma and small-cell carcinoma, 1–3 primary lymphoma, 4 cervical choriocarcinoma, 5 sarcoma of the uterine cervix, 6 malignant melanoma, 7 Wilm’s tumor, 8 and malignant peripheral neurilemmoma of cervical fibroblasts. Squamous cell carcinoma is the most common primary tumor in the cervix.
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