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

Abstract

Rationale:Primary squamous cell carcinoma of the endometrium (PSCCE) is a rare entity, and only sporadic cases have been reported in the literature since the 1st report in 1892. This report describes a case of a perimenopausal woman with PSCCE.Patient concerns:A 47-year-old, human papilloma virus type 16-positive, perimenopausal woman was admitted to our hospital with irregular vaginal bleeding for 6 months and secondary anemia.Diagnoses:The patient was diagnosed with stage IIIc primary and moderately differentiated endometrial squamous cell carcinoma.Interventions:The patient underwent diagnostic curettage twice and cold knife conization (CKC). Following this total abdominal hysterectomy combined with bilateral adnexectomy and pelvic lymph node, dissection was performed. After the surgery, the patient was treated with radiotherapy and chemotherapy. Tumor markers were followed up regularly after the operation to monitor tumor recurrence and therapeutic effect.Outcomes:Ninety-two days after the operation, there was tumor recurrence of the left pelvic cavity and the patient died after 11 months of follow-up.Lessons:Intrauterine pathology after the 1st diagnostic curettage suggests that high-grade squamous intraepithelial lesion should make the clinician vigilant and investigate the origin of the lesion. Magnetic resonance imaging scans and tumor markers can be used to confirm the diagnosis as soon as possible and avoid unnecessary interventions like CKC.

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

“…The reason for this low pre‐operative diagnosis rate is the highly differentiated appearance of the squamous epithelium and/or often very scanty material 4 . The few atypical squamous cells are often interpreted as a cervical high‐grade squamous intraepithelial lesion, evoking in some cases a conisation procedure 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.…”

“…There are approximately 100 cases of PSCCE reported in the literature. 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.…”

Primary Squamous Cell Carcinoma of the Endometrium : A Rare Case in the Philippines

“…Total hysterectomy with bilateral salpingo-oophorectomy with post-operative chemotherapy with Carboplatin and Paclitaxel every 21 days for 6 cycles and External Beam Radiotherapyis recommended treatment for menopausal women [6]. One case reported their 2 patients underwent radical surgery and received external beam radiation followed by vaginal brachytherapy have obtained good clinical result [12]. Our patient was counselled regarding post-operative therapy and prognosis but she opted to seek second opinion with another Gynecologic Oncologist.…”

Proceedings of the 2021 National Toxicology Program Satellite Symposium

“…60 In women, primary SCC of the endometrium is also extremely rare, but aggressive and associated with a poor prognosis. 61 Primary SCC is defined by a lack of coexistence of endometrial adenocarcinoma present, no connection to cervical or vaginal squamous epithelium, and no coexistence of SCC of cervix. 62 Case reports describe similar moderately differentiated neoplastic cells as observed in this case.…”

“…62 Case reports describe similar moderately differentiated neoplastic cells as observed in this case. 61 During the audience discussion, audience members described similar experiences in chronic/carcinogenicity studies with occasional endometrial adenocarcinomas and rare uterine SCCs in aged female rats. Additionally, the importance of establishing the potential involvement of the cervix with all squamous findings within the uterus was reiterated by audience members and Dr Plumlee alike.…”