Unusual form of squamous cell carcinoma of the cervix extending in situ into the endometrium: Three case reports and review of literature
A 65-year-old female (Para 5, Live 4, Abortion 1), ten- year post- menopausal was investigated for an abnormal Papanicolaou (PAP) smear. Clinically, there was mild cervical stenosis with pyometra. There was no other significant medical history. A punch biopsy confirmed the diagnosis of an infiltrating squamous cell carcinoma of the cervix, non-keratinizing, of a large cell type. With the clinical diagnosis of cervical carcinoma, Stage I-B, Wertheim's hysterectomy was performed. The uterus weighed 70 g and revealed cervical stenosis, but no obstruction. On gross examination, the uterus and cervix measured 8 × 5 × 4 cm. The cervix was completely replaced by gray–white circumferential growth. The endometrial cavity was dilated and the endometrial surface had a gray–white corrugated appearance. Microscopically, the cervical lesion consisted of squamous cell carcinoma, moderately differentiated and extending up and over the endometrial surface of the lower uterine segment as carcinoma in situ, without involvement of the underlying myometrium. The tumor extended up to the right parametrium, but the vaginal cuff, both fallopian tubes, and ovaries were unremarkable.