The neoplasia starts in a preinvasive stage. The time of development to invasive cancer can be short, but usually takes multiple years. At the transition to invasive cancer, the tumor cells disrupt the basal membrane and grow into cervical stromal tissue. Tumor cells then grow further into the parametrium and can break through the bladder wall or rectum.
The tumor may cause ureter compression by invasion of parametrial tissue. On the cervix, the tumor may be exophytic or necrotic, and the cervical diameter will often increase.
Tumor cells can invade blood and lymph vessels and discharge metastases to pelvic lymph nodes, paraaortic lymph nodes, and in rare cases, to mediastinal or supraclavicular lymph nodes. The frequency of metastases to lymph nodes increases with increasing tumor volume and stage.
By invasion of blood vessels, tumor cells can migrate to the lungs causing lung metastases.
Liver metastases do also occur, but are rare at the time of diagnosis, and more frequent with later recurrences.