Cervical cancer may present in uncommon and complex clinical settings, including de novo metastatic disease, occult cancer incidentally diagnosed after simple hysterectomy and cervical stump cancer after supracervical hysterectomy.

A literature review was conducted using PubMed/MEDLINE, the Cochrane Library and Scopus. English- and French-language publications available through September 2025 were qualitatively analyzed according to their methodological quality, level of evidence and clinical relevance.

In de novo metastatic cervical cancer, platinum-based chemotherapy remains the backbone of systemic treatment. BEVACIZUMAB and PEMBROLIZUMAB have improved outcomes in trials combining de novo metastatic, persistent and recurrent disease, although their specific benefit in the de novo subgroup remains less clearly established. Local treatment of oligometastases has been associated with prolonged survival in selected patients, but controlled comparative evidence is lacking. For occult cervical cancer after simple hysterectomy, favorable outcomes without additional treatment have been reported in selected patients with small tumors, limited stromal invasion, negative margins and no nodal involvement. Completion surgery and radiotherapy-based treatments have achieved disease control in patients with more extensive disease or adverse pathological features, but their comparative efficacy remains uncertain. In cervical stump cancer, historical series suggest that external beam radiotherapy combined with brachytherapy provides effective locoregional control. Evidence regarding contemporary image-guided brachytherapy is limited, while completion surgery after radiotherapy has been associated with substantial morbidity without demonstrated improvement in disease control.

The available evidence remains limited by heterogeneous populations, historical staging and treatment techniques, selection bias, and the absence of prospective controlled comparisons.