Primary squamous cell carcinoma of the endometrium: Case history, pathologic findings, and discussion

Abstract

Primary squamous cell carcinoma of the endometrium (PSCCE) is an exceedingly rare tumor. Rarely are cytological criteria discussed. We report our experience in the cytological diagnosis of a case. A postmenopausal, 64-yr-old woman suffered from pyometria. An endometrial Pap smear displayed some malignant squamous cells. Curettage of the cervix and the uterine cavity only recovered some fragments of atypical squamous epithelium whose origin could not be precisely identified. A hysterectomy with bilateral adnexectomy was decided upon. Pathological study evidenced a primary squamous cell carcinoma in the uterine cavity while the cervix was tumor-free and the lymph nodes were devoid of metastases (pT1, pN0, pM0). The patient died 46 mo PO with multiple pulmonary and renal metastases. The histological feature of PSCCE is identical to that of any tumor of a similar nature, whatever the site, especially the cervix. Confirmation of the primary endometrial nature is only possible on the hysterectomy specimen.

Primary squamous cell carcinoma of the endometrium—Case report with cytological characteristics in direct and indirect endometrial samples

“…3,6 Similarly, the first curettage sample in our case was interpreted as benign (a possibility of contamination with exocervical epithelium), while the second curettage was histopathologically inconclusive, both as a result of the lack of underlying stroma. Both endometrial aspirates, as also in two other reports, 7,8 contained an abundance of abnormal squamous cells and necrosis, and cytology presumed that the primary lesion was in the uterine cavity, notwithstanding some abnormal squamous cells in the Pap smear.…”

“…There are approximately 100 cases of PSCCE reported in the literature 2 . Pap smear findings are reported several times 3‐6 and cytology of direct endometrial sampling on only two occasions 7,8 . We found one report of peritoneal washing cytology, without malignant cells 6 .…”

“…2 Pap smear findings are reported several times [3][4][5][6] and cytology of direct endometrial sampling on only two occasions. 7,8 We found one report of peritoneal washing cytology, without malignant cells. 6 In the available literature, there are no reports of applying CINtec® PLUS on Pap smears concerning the diagnosis of PSCCE, nor of immunocytochemistry on peritoneal washing samples.…”

PAX8 Positivity, Abnormal p53 Expression, and p16 Negativity in a Primary Endometrial Squamous Cell Carcinoma: A Case Report and Review of the Literature

“…In a case report, pathologic diagnosis of the curettage was high-grade squamous intraepithelial lesion, thus a conization was performed before understanding that it was a PESCC 13. While in other case reports, the curettage biopsy and uterine discharge cytology luckily revealed squamous cell carcinoma 6,10 in our case the histologic picture of the preoperative curettage was clear carcinoma with squamous differentiation already infiltrating the myometrium.…”

Primary squamous cell carcinoma of the endometrium in a woman of perimenopausal age

“…We did not have a reasonable explanation for this. Almost all types of endometrial cancer are adenocarcinomatous, [3] and most of the endometrial squamous carcinomas originate from the SCC of the cervix [4] or endometrial stem cell, and squamous metaplasia of the normal endometrium. [5] Primary endometrial SCC is a rare entity.…”