Superficial spreading cervical squamous cell carcinoma in situ with extensive endomyometrial infiltration masquerading as a primary endometrial cancer


  • H J Olivier Ampath Pathology Laboratories
  • L C Snyman University of Pretoria
  • E Oliva Harvard Medical School
  • T Slavik Ampath Pathology Laboratories


superficial spreading, cervical squamous cell carcinoma, secondary endomyometrial infiltration, primary endometrial squamous cell carcinoma, human papillomavirus


The presence of squamous cell carcinoma (SCC) on endometrial histology raises the possibility of a primary endometrial carcinoma, as well as secondary endometrial involvement by SCC from another site, especially the cervix. This distinction relies on numerous cardinal clinical and pathologic findings and may occasionally be problematic. We document an unusual tumour in a postmenopausal woman who presented with clinical and radiologic features of a primary endometrial cancer, confirmed on endometrial histology as a keratinising SCC. Subsequent pathologic evaluation of the hysterectomy specimen, however, demonstrated an exclusively in situ cervical SCC, with extensive endometrial intramucosal spread and widespread infiltration of the myometrium, macroscopically mimicking a primary endometrial neoplasm. We review the pathologic distinction between primary endometrial SCC and secondary corpus involvement of cervical SCC, as well as the broader differential diagnosis when SCC is identified on endometrial histology.

Author Biographies

H J Olivier, Ampath Pathology Laboratories

Ampath Pathology Laboratories, South Africa

L C Snyman, University of Pretoria

Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Pretoria, South Africa

E Oliva, Harvard Medical School

Department of Pathology, Massachusetts General Hospital and Harvard Medical School, United States of America

T Slavik, Ampath Pathology Laboratories

Ampath Pathology Laboratories and Division of Pathology, Faculty of Health Sciences, University of Pretoria, South Africa