Unusual form of squamous cell carcinoma of the cervix extending in situ into the endometrium: Three case reports and review of literature
A 60-year-old female (Para 2, Live issues 2), five years postmenopausal, presented with a four-month history of vaginal bleeding and discharge. The pelvic examination revealed an enlarged uterus, with a firm mass occupying the cervix. A cervical biopsy revealed invasive squamous cell carcinoma, of a large cell non-keratinizing type. A radical vaginal hysterectomy with pelvic and para-aortic lymph node dissection was performed. A 140 g uterus revealed a gross cervical lesion. The endometrial cavity was roughened with gray–white patches. Microscopically, the cervical lesion again revealed features of squamous cell carcinoma, of the large cell non-keratinizing type, extending up and lining the endometrial surface. There was no evidence of the remaining normal endometrial glands and stroma. The entire endometrial surface was totally replaced with squamous cell carcinoma in situ, with few small foci of microinvasion, associated with extensive inflammatory cell infiltrate. The pelvic and para-aortic lymph nodes were negative for metastasis.