A case of squamous cell carcinoma of the uterine cervix with diffuse hematogenous lung metastasis in a 36-year-old virgin

Abstract

The carcinoma of the uterine cervix in virgins is extremely rare. A 36-year-old virgin presented with a 4.8 × 2.2 cm sized endocervical mass with bleeding on sonography. Biopsy revealed a squamous cell carcinoma arising in the uterine cervix without human papilloma virus (HPV) DNA. Positron emission tomography revealed cervical cancer with multiple hematogenous lung metastases. After 3 cycles of preoperative chemotherapy, she underwent modified radical hysterectomy and 6 cycles of postoperative chemotherapy. After the treatment, complete resolution was obtained, and she has been followed without recurrence for 4 years. Although > 90% of cervical cancer is caused by HPV infection, we cannot completely deny the possibility of HPV negative cervical carcinoma. [3] reanalyzed HPV-negative cases from the IBSCC study and claimed that the worldwide HPV prevalence in cervical carcinomas was 99.7 percent. However, even with this prevalence, the possibility of HPV unrelated carcinomas still needs to be considered. We performed a literature search in Ovid MEDLINE and PubMed with key words, "cervical cancer, and/or virgin, and/or HPV negative" and identifi ed only 4 cases reported between January 1966 and July 2008 [4,5]. Here we report one case of HPV negative, squamous cell carcinoma of the uterine cervix with diffuse hematogenous lung metastasis in a 36-year-old woman whose hymen was completely intact.