Korean J Obstet Gynecol.  2012 Jul;55(7):513-516. 10.5468/KJOG.2012.55.7.513.

A Case of Squamous Cell Carcinoma of Cervix Superficial Spreading to the Entire Endometrium and Bilateral Ovaries Invasively Through Bilateral Tubal Serosal Penetration

• Joo JK
• Kang JH
• Joo IS
• Park Y
• Lee JW
• Seo KY

• KMID: 1992562
• DOI: http://doi.org/10.5468/KJOG.2012.55.7.513

Abstract

Squamous cell carcinoma is one of the commonest malignancies of the uterine cervix and it is a significantly rare phenomenon of metastases to the bilateral ovaries by endometrial and transtubal spreading in the absence of lymph node involvement. The data is limited because it is still difficult to determine the optimal treatment and the prognostic significance is uncertain. We report a 66-year-old woman with squamous cell carcinoma, International Federation of Gynecology and Obstetrics stage Ia2, without previous radiation therapy, associated with superficial spreading squamous cell cervical carcinoma involving the entire endometrial cavity, bilateral tubes and bilateral ovaries.

Keyword

Squamous cell cervical carcinoma; Superficial spreading; Adnexal invasion

MeSH Terms

Aged
Carcinoma, Squamous Cell
Cervix Uteri
Endometrium
Female
Gynecology
Humans
Lymph Nodes
Neoplasm Metastasis
Obstetrics
Ovary

Figure

• 

  Fig. 1 Squamous cell cervix carcinoma (cervix) (H&E, ×100).

• 

  Fig. 2 Histopathological finding of endometrial involvement with squamous cell cervix carcinoma (H&E, ×100).

• 

  Fig. 3 On low power view of Fallopian tube involvement with squamous cell cervix carcinoma (H&E, ×10).

• 

  Fig. 4 On low power of ovarian involvement with squamous cell cervix carcinoma (H&E, ×10).

Reference

1. Canavan TP, Doshi NR. Cervical cancer. Am Fam Physician. 2000. 61:1369–1376.

2. Toki N, Tsukamoto N, Kaku T, Toh N, Saito T, Kamura T, et al. Microscopic ovarian metastasis of the uterine cervical cancer. Gynecol Oncol. 1991. 41:46–51.

3. Tabata M, Ichinoe K, Sakuragi N, Shiina Y, Yamaguchi T, Mabuchi Y. Incidence of ovarian metastasis in patients with cancer of the uterine cervix. Gynecol Oncol. 1987. 28:255–261.

4. Tan GC, Isa MR, Ng SP, Jamil YM. Unusual form of superficial spreading microinvasive squamous cell carcinoma of uterine cervix involving the endometrium of uterus. J Obstet Gynaecol Res. 2004. 30:363–367.

5. Kim DB, Yi JK, Rheu KJ, Chung JK. Epidemiology of cancer of the cervix. Korean J Obstet Gynecol. 1984. 52:1171–1176.

6. Razquin S, Mayayo E, Antón E, Alvira R. Squamous cell carcinoma in situ of the endometrium as superficial extension of cervical carcinoma. Gynecol Obstet Invest. 1993. 35:190–192.

7. Gungor T, Altinkaya SO, Ozat M, Akbay S, Mollamahmutoglu L. Unusual form of superficial spreading squamous cell carcinoma of cervix involving the endometrium, bilateral tubes and ovaries: a case report with literature review. Arch Gynecol Obstet. 2011. 283:323–327.

8. Sakuragi N, Takeda N, Hareyama H, Fujimoto T, Todo Y, Okamoto K, et al. A multivariate analysis of blood vessel and lymph vessel invasion as predictors of ovarian and lymph node metastases in patients with cervical carcinoma. Cancer. 2000. 88:2578–2583.

9. Shimada M, Kigawa J, Nishimura R, Yamaguchi S, Kuzuya K, Nakanishi T, et al. Ovarian metastasis in carcinoma of the uterine cervix. Gynecol Oncol. 2006. 101:234–237.

10. Perez CA, Camel HM, Askin F, Breaux S. Endometrial extension of carcinoma of the uterine cervix: a prognostic factor that may modify staging. Cancer. 1981. 48:170–180.

11. Gupta S, Gupta IM, Tiwari PV. In-situ carcinoma of the uterine cervix showing superficial endometrial spread. Acta Obstet Gynecol Scand. 1979. 58:507–508.

12. Kushima M, Fujii H, Murakami K, Ota H, Matsumoto T, Motoyama T, et al. Simultaneous squamous cell carcinomas of the uterine cervix and upper genital tract: loss of heterozygosity analysis demonstrates clonal neoplasms of cervical origin. Int J Gynecol Pathol. 2001. 20:353–358.