Small preulcerative invasive carcinoma of the cervix: The spray carcinoma

In the majority of cases of solid cervical carcinoma the carcinoma starts by transformation of the epithelium into a surface carcinoma with the latent prospective tendency of downgrowth. This period of latency of invasion shows great variation, from a few days to several years. There is a second mode of carcinogenesis in the cervix. The carcinomatous transformation is limited to the basal Malpighian zone of the squamous epithelium, starting invasion immediately after transformation of the basal zone into carcinoma. In such cases the upper external surface zone of the epithelium remains unchanged and normal, while the carcinoma in the depth starts invasion by down-growth, sometimes by masses composed of carcinoma cells, sometimes by single cells developing from the basalis. For the latter type of initial carcinoma the term spray carcinoma is suggested. There is no change of the surface that would indicate carcinomatous invasion in the depth. Consequently, methods suggested for detection of surface carcinoma, as colposcopy, iodine test, Papanicolaou and Ayre smears, are of no avail.