CARCINOMA IN SITU AND BASAL CELL HYPERPLASIA OF THE CERVIX UTERI.

ARCINOMA in situ of the cervix uteri and allied lesions is one of the commoner forms of cancer in the female and anything which contributes to a reduction in its incidence is worthy of investigation and consideration. It is primarily with this aim in mind that we wish to discuss and present several cases of carcinoma in situ and allied lesions of the cervix which have come our way in the past three years (1960-1962) at Dr. Steevens' Hospital. It is widely accepted Vhat there is a histologically recognisab]e stage in the development of squamous cell carcinoma of the cervix during which the tumour is confined to the natural epithelial surfaces and endocervieal glands and with no evidence of stromal invasion; or, to put it .another way, there is an altera*tion of the surface epithelium which shows the cytological abnormalities seen in invasive carcinoma, but presents no evidence of invasion)2 ~ 11 13 1~ The exact degree of cytological alteration required to justify calling a lesion in situ carcinoma unfortunately causes differences of opinion and lhe only feature on which .there is unanimiiy is, that the lesion is confined to the natural surfaces of the cervix. The development of in situ carcinoma is by no means confined to the cervix and may occur in the skin and mucous membranes elsewhere. The lesion with its many synonyms (pre-invasive carcino,ma; Bowen's disease; intra-epithelial carcinoma and pre-cancerous met aplasia) has an interesting history. Schawenstein (1908) first drew attention to the striking similarity between the histological pattern of non-invasive and invasive cancer of the cervix. Rubins '(1910), U.S.A., discussed the possibility of making the .diagnosis of cancer before invasion occurred and he pointed out that the most important criterion of malignancy is not the presence or absence of stromal invasion, its depth and extenr but lies in the morphology of the cell. He suggested that cytological atypism is an adequate criterion of malignancy even in the absence of stromal invasion.