Papillary Squamous Cell Carcinoma of the Uterine Cervix, High-Risk Human Papilloma Virus Infection and p16INK4a Expression

Eleutério, José; Giraldo, Paulo César; Cavalcante, Diane Isabelle Magno; Gonçalves, Ana Katherine; Eleutério, Renata Mírian Nunes; Giraldo, Helena

doi:10.1159/000325122

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…Further, the two patients with recurrence both had high risk HPV expression ( Mirhashemi et al, 2003 ). More recent case reports have detected HPV expression in PSCC ( Tang et al, 2013 , Sawada et al, 2010 , Eleuterio et al, 2009 , Brinck et al, 2000 ). One case report notes no evidence of recurrence after 10 months ( Sawada et al, 2010 ).…”

Section: Discussionmentioning

confidence: 94%

Papillary squamous cell carcinoma of the cervix: Two cases and a review of the literature

Turker

Gressel

Abadi

et al. 2016

Gynecologic Oncology Reports

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ObjectivePapillary squamous cell carcinoma of the cervix (PSCC) is a rare and distinct form of cervical carcinoma. Detecting stromal invasion on biopsy is difficult due to the papillary growth of the tumor. Here we present two cases that highlight the diagnostic and clinical challenges of PSCC.Case 1A 50-year-old woman found to have carcinoma on a routine pap-smear. The patient was diagnosed with PSCC on colposcopic biopsy and underwent a radical hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection. Her final pathology demonstrated PSCC with no evidence of stromal invasion. At her 3-month follow up visit, she was noted to have a tumor recurrence at the vaginal cuff, again with no stromal invasion. She is currently undergoing definitive radiation therapy with sensitizing cisplatin.Case 2An 82-year-old woman presented with post-menopausal bleeding and was found to have an exophytic mass. Biopsies were taken and showed PSCC with no stromal invasion identified. She underwent a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Final pathology indicated no invasion. She is currently being followed for persistent vaginal dysplasia.ConclusionPSCC is a rare tumor that has previously been described as less aggressive than classical squamous cell carcinoma. These two cases demonstrate the complex behavior of the disease. Case 1 highlights that PSCC may recur even when stromal invasion cannot be confirmed pathologically.

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Section: Discussionmentioning

confidence: 94%

Papillary squamous cell carcinoma of the cervix: Two cases and a review of the literature

Turker

Gressel

Abadi

et al. 2016

Gynecologic Oncology Reports

View full text Add to dashboard Cite

show abstract

“…The authors also stated that eight (67%) of 12 PSCC cases exhibited a high proliferative activity, whereas five (83%) of six HPV-16-positive PSCC lesions demonstrated a high proliferative activity on Ki-67 immunostaining. Based on these biological data, PSCCs are proliferatively active tumors [ 9 , 10 ]. However, Randall reported that two of nine patients developed recurrence more than seven years (87 and 106 months) after diagnosis [ 1 ], and Koenig also noted vaginal recurrence 12 years after the initial diagnosis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical approaches to treating papillary squamous cell carcinoma of the uterine cervix

et al. 2014

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BackgroundPapillary squamous cell carcinoma (PSCC) of the uterine cervix is difficult to diagnose due to its rarity and limited data regarding its clinical behavior. We attempted to assess the degree of stromal invasion using magnetic resonance imaging (MRI) and evaluate possible treatments for this lesion in view of its clinical behavior.MethodsWe analyzed 28 cases of PSCC diagnosed on the colposcopic selective biopsies. We studied the rate of accuracy of diagnoses of the colposcopic selective biopsies compared with the final diagnoses, and compared the rate of stromal invasion between the MRI and pathological findings while focusing on surgical methods and the clinical prognosis.ResultsOf the 28 patients, only 12 exhibited true PSCC. The other 16 patients were ultimately diagnosed with SCC or adenosquamous carcinoma based on the finding of the surgical specimens and exhibited relatively poor prognoses. Among the 12 true PSCC cases, the rate of diagnostic accuracy of stromal invasion (with or without) was only 58% (7/12) on the colposcopic selective biopsies. However, we were able to predict the presence of stromal invasion (microscopic borderline: approximately 3 mm) before surgery using MRI. None of the 10 patients treated with radical surgery displayed lymph node metastases. In addition, all 12 study patients exhibited no recurrence (mean: 49 months) and survived.ConclusionsMRI can be used to detect preinvasive and microinvasive disease before surgery. It is possible to select a less invasive surgical method than radical surgery in cases of preinvasive and microinvasive PSCC in view of the indolent clinical behavior of this disease.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2407-14-784) contains supplementary material, which is available to authorized users.

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“…also proposed the important role of MRI for the precise diagnosis of PSCC ( 2 ). Other studies have suggested that patients with visible lesions should directly undergo radical hysterectomy; however, because of the small sample size, the level of evidence might be low ( 7 , 13 , 18 , 19 ).…”

Section: Discussionmentioning

confidence: 95%

“…PSCC grows superficially in an exophytic manner ( 8 ),this pattern of growth is different from that of traditional squamous cervical cancer ( 9 ). Few studies of PSCC have been conducted, and their sample sizes ranged from 1 to 55 cases ( 3 , 4 , 10 – 13 ). Moreover, the final staging of PSCC is unknown.…”

Section: Discussionmentioning

confidence: 99%

Value of loop electrosurgical excision procedure conization and imaging for the diagnosis of papillary squamous cell carcinoma of the cervix

et al. 2023

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BackgroundLoop electrosurgical excision procedure (LEEP) conization and hysterectomy are performed for some patients with papillary squamous cell carcinoma (PSCC), whereas only hysterectomy is performed for others. We aimed to determine the optimal management for PSCC.MethodsPatients diagnosed with PSCC by colposcopy-directed biopsy between June 2008 and January 2020 who underwent LEEP conization and hysterectomy or only hysterectomy at our hospital were enrolled. Results of cervical cytology, high-risk human papillomavirus testing, transvaginal sonography, pelvic magnetic resonance imaging, LEEP, hysterectomy, and pathology testing of colposcopy-directed biopsy samples were analyzed.ResultsA total of 379 women were diagnosed with PSCC by colposcopy-directed biopsy; 174 underwent LEEP before hysterectomy and 205 underwent only hysterectomy. Patients underwent and did not undergo LEEP were aged 47 ± 11 years and 52 ± 11 years, respectively. Among women who underwent LEEP, the agreement between LEEP and hysterectomy pathology was 85.1%. For women who underwent only hysterectomy, the agreement between preoperative clinical staging and pathological staging after hysterectomy was 82.4%. For patients with preoperative imaging indicative of malignancy, the accuracy of LEEP for diagnosing and staging PSCC was 88.5%, whereas for the hysterectomy-only group, it was 86.2%. For patients without malignancy detected with imaging, the accuracy of LEEP for diagnosing and staging PSCC was 81.6%; however, for those who did not undergo LEEP, it was 70.0%.ConclusionFor women diagnosed with PSCC by colposcopy-directed biopsy, LEEP conization is necessary for an accurate diagnosis when imaging does not indicate cancer; however, LEEP is not necessary when imaging indicates cancer.

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Papillary Squamous Cell Carcinoma of the Uterine Cervix, High-Risk Human Papilloma Virus Infection and p16INK4a Expression

Cited by 8 publications

References 12 publications

Papillary squamous cell carcinoma of the cervix: Two cases and a review of the literature

Papillary squamous cell carcinoma of the cervix: Two cases and a review of the literature

Clinical approaches to treating papillary squamous cell carcinoma of the uterine cervix

Value of loop electrosurgical excision procedure conization and imaging for the diagnosis of papillary squamous cell carcinoma of the cervix

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