Korean J Pathol.  2013 Dec;47(6):549-556.

Primary Squamous Cell Carcinoma of the Upper Genital Tract: Utility of p16INK4a Expression and HPV DNA Status in its Differential Diagnosis from Extended Cervical Squamous Cell Carcinoma

• Yoo SH
• Son EM
• Sung CO
• Kim KR

Abstract

BACKGROUND
Primary squamous cell carcinoma (SCC) of the upper genital tract, including the endometrium, fallopian tubes, and ovaries, is extremely rare. It must be distinguished from the mucosal extension of primary cervical SCC because determination of the primary tumor site is important for tumor staging. However, patients with SCC of the fallopian tubes or ovarian surface have often undergone prior hysterectomy with inadequate examination of the cervix, making it difficult to determine the primary site.
METHODS
We compared histologic findings, p16INK4a expression, and human papillomavirus (HPV) DNA status in four patients with primary SCC of the upper genital tract and five patients with primary cervical SCC extending to the mucosa of the upper genital tract.
RESULTS
All five SCCs of cervical origin showed strong expression of p16INK4a, whereas all four SCCs of the upper genital tract were negative, although one showed weak focal staining. Three of the five cervical SCCs were positive for HPV16 DNA, whereas all four primary SCCs of the upper genital tract were negative for HPV DNA.
CONCLUSIONS
Although a thorough histological examination is important, immunonegativity for p16INK4a and negative for HPV DNA may be useful adjuncts in determining primary SCCs of the upper genital tract.

Keyword

Carcinoma, squamous cell; Genes, p16; DNA probes, HPV

MeSH Terms

Carcinoma, Squamous Cell*
Cervix Uteri
Diagnosis, Differential*
DNA Probes, HPV
DNA*
Endometrium
Fallopian Tubes
Female
Genes, p16
Humans
Hysterectomy
Mucous Membrane
Neoplasm Staging
Ovary
DNA
DNA Probes, HPV