Abstract
BACKGROUND: Serous carcinoma of the uterine cervix (USCC) represents a rare subtype of cervical adenocarcinoma, classified into human papillomavirus (HPV)-independent and HPV-associated types. It is characterized by high invasiveness and poor prognosis, with limited global reports on this condition. CASE SUMMARY: A 58-year-old Chinese woman presented with painless vaginal bleeding after sexual intercourse, which appeared as droplets. HPV testing and histopathological analysis confirmed the diagnosis of HPV-associated primary serous carcinoma of the USCC. The patient underwent radical hysterectomy and was diagnosed with primary serous carcinoma of the uterine cervix, stage III C2 (FIGO 2018). A multimodal treatment approach, including surgery, radiotherapy, and chemotherapy, was administered. After additional concurrent chemoradiotherapy and three cycles of chemotherapy, the patient showed no evidence of disease progression and achieved long-term survival for 53 months. CONCLUSION: USCC is a rare and aggressive malignancy. Upon diagnosis, multimodal treatment strategies, including surgery, radiotherapy, and chemotherapy, can effectively prolong patient survival and improve prognosis.