Squamous cell carcinoma in situ lining the uterine cavity

Cervical intra-epithelial neoplasia is a very common and well-known pathology. However superficial spreading of this lesion is very rare. The authors present a case of a 72-year-old woman with an abdominal mass, who had previously undergone a cervical conisation for a high-grade cervical intra-epithelial neoplasia. Anatomo-pathological examination of the mass showed a large distended fluid-filled uterus with the entire endometrium replaced by a high-grade squamous cell lesion. There were only micro-invasive foci found. The authors performed a literature search in PubMed with the following MeSH-terms: "squamous cell carcinoma" and "endometrium". Other articles were selected out of the references of previously found articles. Only 31 similar cases were found. The presentation of the cases is varies extremely and a long-term prognosis is not yet known.

Squamous cell carcinoma; Endometrium: Cervical intra-epithelial neoplasia; Superficial spreading.

[1] Marwah N., Garg M., Singh S., Sethi D., Rajeev S.: “Unusual form of squamous cell carcinoma of the cervix extending in situ into the endometrium: Three case reports and review of the literature”. Int. J. App. Basic Med. Res. 2012, 2,139.

[2] Gungor T., Altinkaya S.O., Ozat M. Akbay S., Mollamahmutoglu.: “Unusual form of superficial spreading squamous carcinoma of cervix involving the endometrium, bilateral tubes and ovaries: a case report with literature review”. Arch. Gynecol. Obstet., 2011, 283, 323.

[3] Ishida M., Okabe H.: “Superficial spreading squamous cell carci-noma of the uterine cervix involving the endometrium: report of two cases with emphasis on the likely molecular mechanism”. Oncol. Lett., 2013, 5, 31.

[4] Gupta S., Gupta I.M., Tiwari P.W.: “In-situ carcinoma of the uterine cervix showing superficial endometrial spread”. Acta. Obstet. Gy-necol. Scand., 1979, 58, 507.

[5] Razquin S., Mayayo E., Anton E., Alvira R.: “Squamous cell carci-noma in situ of the endometrium as superficial extension of cervical carcinoma”. Gynecol. Obstet. Invest., 1993, 35, 190.

[6] Kushima M. Fujii H, Murakami K, Ota H, Matsumoto T, Motoyama T., et al.: “Simultanous cell carcinomas of the uterine cervix and upper genital tract: loss of heterozygosity analysis demonstrates clonal neo-plasms of cervical origin”. Int. J. Gynecol. Pathol., 2001, 20, 353.

[7] Tan G.C., Isa M.R., Ng. S. P., Jamil Y.M.: “Unusual form of super-ficial spreading microinvasive squamous cell carcinoma of uterine cervix involving the endometrium of uterus”. J. Obstet. Gynaecol. Res., 2004, 30, 363.

[8] Agashe S.R., Kulkami M.P., Momin Y. A., Sulhyan K.R.: “Superfi-cial extension of squamous cell carcinoma in situ of cervix involv-ing endometrium, bilateral fallopian tubes and ovaries: a case report”. Indian J. Pathol. Microbiol., 2007, 50, 375.

[9] Kanbour A.I., Stock R.J.: “Squamous cell carcinoma in situ of the en-dometrium and fallopian tube as superficial extension of invasive cervical carcinoma”. Cancer, 1978, 42, 570.

[10] Pins M.R., Young R.H., Crum C.P., Leach I.H., Scully R.E.: “Cervi-cal squamous cell carcinoma in situ with intraepithelial extension to the upper genital tract and invasion of tubes and ovaries: report of a case with human papilloma virus analysis”. Int. J. Gynecol. Pathol., 1997, 16, 272.

[11] Motoyama T., Watanabe H.: “Squamous cell carcinoma of the cervix with extensive superficial spreading to almost whole genital tract and associated with endometrial stromal sarcoma”. Acta. Pathol. Jpn., 1988, 38, 1445.

[12] Quizilbash A.H., DePetrillo A.D.: “Endometrial and tubal involvement by squamous carcinoma of the cervix”. Am. J. Clin. Pathol., 1975, 64, 668.

[13] Punnonen R., Grönroos M., Vaajalahti P.: “Squamous cell carcinoma in situ from the uterine cervix to the distal end of the fallopian tube”. Acta. Obstet. Gynecol. Scand., 1979, 58, 101.

[14] Schmitt K., Schäfer A.: “Intraepithelial spread of the squamous cell carcinoma of the uterine cervix into the endometrium. A con-tribution to the question of a suface spread of the cervical carci-noma”. Z. Krebsforsch. Klin. Onkol. Cancer Res. Clin. Oncol., 1977, 89, 45.

[15] Kamalian N., Ghafoorzadeh D.: “Squamous cell carcinoma of the cervix, with extension in an in situ fashion into the endometrium”. Int. J. Gynaecol. Obstet., 1977, 15, 267.

[16] Daniele E., Perino A., Catinalla E.: “Superficial endometrial in-volvement by cervical intraepithelial neoplasia detected by in-trauterine cytology. A case report”. Acta Cytol., 1985, 29, 411.

[17] Teixeira M. de Magalhães F.T., Pardal-de-Oliveira F.: “Squamous cell carcinoma of the endometrium and cervix”. Int. J. Gynaecol. Obstet., 1991, 35, 169.