Unusual form of squamous cell carcinoma of the cervix extending in situ into the endometrium: Three case reports and review of literature
A 49-year-old female (Para 4, Live issues 4) presented with post-menopausal bleeding since the last two months, associated with foul smelling discharge. She also gave a history of burning micturition since the last one month. The patient had been menopausal for the past five years, was married at the age of 15, and had four full-term spontaneous vaginal deliveries. Her first child was delivered at the age of 18 years. There was no past medical or surgical history that was significant. Pelvic examination revealed a firm cervix, flushed with vagina. A cervical punch biopsy was performed, which revealed squamous cell carcinoma of the cervix, non-keratinizing, of large cell type. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, and the specimen was submitted for histopathological evaluation. Gross examination of the specimen revealed a slightly bulky uterus measuring 18 × 14 × 8 cm. The external surface of the uterus appeared smooth. On sectioning of the specimen, a superficial yellowish growth was seen extending from the endocervical canal to the fundus of the endometrial cavity. Microscopically, malignant squamous cells were seen extending superficially and continuing from the cervix lip to the fundus of the uterus []. No vascular or lymphatic invasion was noted. The vaginal cuff also showed extension of squamous cell carcinoma in a superficial manner []. The fallopian tubes and ovaries were free of tumor spread.