Squamous cell carcinoma in situ of the cervix with superficial intraepithelial extension to the endometrium of lower uterine segment: A rare presentation

Muthusamy, Rajeshwari K; Mehta, Sarah

doi:10.4103/0971-5851.203509

Cited by 5 publications

(8 citation statements)

References 6 publications

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“…Another 4 (15.38%) had cervical stenosis (one case had stenosis post conization performed 16 years ago). [ 11 12 13 14 9 10 ] The cervix was firm flushed with vagina in 3 (11.54%) cases,[ 13 15 16 ] and a visible cervical mass was reported in 11 (42.31%) women. [ 4 12 13 17 18 19 20 21 ]…”

Section: Review and Discussionmentioning

confidence: 99%

A review and case report of enigmatic superficial endometrial spread of cancer of the uterine cervix

Bagde

Hussain

et al. 2021

Journal of Family Medicine and Primary Care

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Cervical cancer is a leading cause of cancer-related morbidity and mortality. It usually spreads via direct invasion and lymphatics. Few cases with superficial spread to the uterine endometrium, fallopian tubes, and ovaries have been observed. The staging of these cases, as well as management, is not yet clear due to limited data. The Federation of Gynecology and Obstetrics (FIGO) staging disregards uterine spread to upstage the disease, and it also fails to provide clear guidelines regarding the superficial extension to the ovaries and tubes which is not uncommon in these cases. A 63-year-old female with postmenopausal bleeding was diagnosed with squamous cell carcinoma on a pap smear. Ultrasound and magnetic resonance imaging revealed a predominant endometrial lesion. Histopathology after Wertheim's hysterectomy revealed a squamous cell carcinoma of the endocervix, stage 1B2, that had spread superficially to the endometrium. A total of 48 cases of cervical cancer with superficial spread were identified. The commonest complaint was postmenopausal bleed in 39.39%. In 50% of the cases, the disease was carcinoma in situ, and 70.45% of the women had disease of stage 1B or less. In many cases, the disease had reached the tubes, 36.66%, and ovaries 23.33%. All women with stage 2A or lesser disease except for one were alive at 6 months after surgery. Superficial spread of cervical cancer is a distinct entity. Endometrial pathology must be ruled out before planning management in these women, especially when managing early-stage disease with conservative therapy.

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Section: Review and Discussionmentioning

confidence: 99%

A review and case report of enigmatic superficial endometrial spread of cancer of the uterine cervix

Bagde

Hussain

et al. 2021

Journal of Family Medicine and Primary Care

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“…Because of the rarity of this phenomenon and limited data, prognostic significance and management guidelines Pathology International are lacking. [1][2][3] Even though our patient was closely followed up with cyto-colposcopic studies at regular intervals, she developed a sudden recurrence at an advanced stage 16 years following conization. In our patient, failure to detect recurrence at an early stage can be explained by the inadequate cyto-colposcopic study due to cervical stenosis.…”

Section: Le Tt Er To T He Edi T Ormentioning

confidence: 93%

“…Although previous studies have suggested that radiation plays a role in pathogenesis, a correlation has not been substantiated in other cases. [1][2][3] Moreover, Kushima et al reported five patients with a similar unusual superficial spread of cervical squamous cell carcinoma; on genetic evaluation, they demonstrated a single clonal process for these tumors with a frequent loss of heterozygosity of 6p, 6q, 11p, and 11q, loci known to be commonly lost in typical cervical squamous cell carcinoma. 5 Furthermore, such tumors (including the present case) exhibited positivity for p16, a surrogate marker for human papilloma viruses, in immunohistochemical analysis.…”

Section: Le Tt Er To T He Edi T Ormentioning

confidence: 99%

“…Although previous studies have suggested that radiation plays a role in pathogenesis, a correlation has not been substantiated in other cases . Moreover, Kushima et al .…”

mentioning

confidence: 91%

“…Because of the rarity of this phenomenon and limited data, prognostic significance and management guidelines are lacking . Even though our patient was closely followed up with cyto‐colposcopic studies at regular intervals, she developed a sudden recurrence at an advanced stage 16 years following conization.…”

mentioning

confidence: 96%

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Superficial spread of cervical squamous cell carcinoma to the upper genital tract and dissemination to the omentum

Nakajima

Hatta

Nishida

et al. 2019

Pathology International

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Superficial spreading cervical squamous cell carcinoma in situ involving the endometrium: a case report and review of the literature

Martín-Vallejo¹,

Laforga²,

Molina-Bellido³

et al. 2022

J Med Case Reports

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Background The spread of cervical squamous cell carcinoma to the inner surface of the uterus with replacement of the endometrium is rare. Continuity of the lesion must be demonstrated to confirm superficial spread and rule out concomitant endometrial cancer. Case presentation We present the case of a 66-year-old white woman with superficial spreading squamous cell carcinoma of the cervix that involved the endometrium. Her relevant past history included conization of the cervix to treat cervical intraepithelial neoplasia III with positive margins. She subsequently had three negative cervical vaginal cytology results, each with a positive high-risk human papillomavirus test. Transvaginal ultrasound showed occupation of the entire uterine cavity by dense material consistent with pyometra in addition to myometrial thinning due to tension and cervical dilation. The patient presented with greenish vaginal discharge of 3 months’ duration. The cervix was not visible during speculum examination. Access for endometrial sampling was not possible, raising suspicion of post-conization cervical stenosis. The patient was treated with laparoscopic hysterectomy with double adnexectomy. Histologic examination showed superficial squamous cell carcinoma invading the cervix to a depth of 2.8 mm; superficial spreading squamous cell carcinoma in situ was also observed in the lower uterine segment and endometrium. The patient was free of symptoms 12 months after surgery. Conclusions Squamous cell carcinoma of the cervix with superficial spread to the endometrium is not included in the 2020 (fifth edition) World Health Organization Classification of Female Genital Tract Tumors or the 2018 International Federation of Gynecology and Obstetrics cervical cancer staging system. More clinical cases are needed to identify other prognostic factors and inform clinical practice guidelines on the management of this disease.

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Squamous cell carcinoma in situ of the cervix with superficial intraepithelial extension to the endometrium of lower uterine segment: A rare presentation

Cited by 5 publications

References 6 publications

A review and case report of enigmatic superficial endometrial spread of cancer of the uterine cervix

A review and case report of enigmatic superficial endometrial spread of cancer of the uterine cervix

Superficial spread of cervical squamous cell carcinoma to the upper genital tract and dissemination to the omentum

Superficial spreading cervical squamous cell carcinoma in situ involving the endometrium: a case report and review of the literature

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