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

Authors

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

Keywords:

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

Abstract

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

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Published

2022-06-13

Issue

Vol. 14 No. 1 (2022)

Section

Case Studies

License

South African Journal of Gynaecological Oncology (SAJGO) Copyright is held by South African Society of Gynaecologic Oncology (SASGO). Copyright of the articles is held by the authors. The work is licensed under a Creative Commons Attribution-Non-Commercial Works 4.0 South Africa License (CC BY NC). Material submitted for publication in the SAJGO is accepted provided it has not been published elsewhere. The SAJGO does not hold itself responsible for statements made by the authors. The opinions expressed in this publication are those of the authors. They do no purport to reflect the opinions or views of SASGO or its members.