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1.  Mesonephric adenocarcinoma with a sarcomatous component, a notable subtype of cervical carcinosarcoma: a case report and review of the literature 
Diagnostic Pathology  2013;8:74.
Abstract
Carcinosarcoma of the uterine cervix is less common than its counterpart in the uterine corpus. On the other hand, mesonephric adenocarcinoma is also a rare neoplasm in the uterine cervix, and it has been reported that mesonephric adenocarcinomas are often accompanied by sarcomatous components. We present a case of mesonephric adenocarcinoma with a sarcomatous component which arose in a 63-year-old postmenopausal woman. The hysterectomy specimen grossly showed an exophytic mass measuring 1.8 cm in the uterine cervix. Histologically, diffuse mesonephric hyperplasia and adenocarcinoma with malignant spindle cell proliferation was recognized, and therefore the tumor was diagnosed as “mesonephric adenocarcinoma with a sarcomatous component.” The review of the literature of cervical carcinosarcoma and cervical mesonephric adenocarcinoma revealed that 16% of cervical carcinosarcoma is of mesonephric duct origin, and that mesonephric adenocarcinoma seems to be more likely to have sarcomatous change. We think the presence of a sarcomatous component in the cervical biopsy specimen could be helpful in the diagnosis of mesonephric duct origin.
Virtual slides
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1243996503911062
doi:10.1186/1746-1596-8-74
PMCID: PMC3652771  PMID: 23651629
Mesonephric adenocarcinoma; Carcinosarcoma; Uterine cervix
2.  A new case of primary signet-ring cell carcinoma of the cervix with prominent endometrial and myometrial involvement: Immunohistochemical and molecular studies and review of the literature 
Background
As a rule, endocervical tumours with signet-ring cell are classed as metastatic extra-genital neoplasms. In a patient aged 45 years, we describe primary cervical signet-ring cell carcinoma (PCSRCC) characterized by prominent endometrial and myometrial involvement, simulating primary endometrial adenocarcinoma with cervical extension. In addition, a review was made of the literature to identify the clinical and pathological features of this rare malignancy.
Case presentation
A 45-year-old woman was referred to our Gynaecology Department due to persistent abnormal vaginal bleeding. Transvaginal ultrasonography showed slight endometrial irregularities in the whole uterine cavity suggestive of endometrial neoplasms. Pelvic magnetic resonance imaging revealed diffuse enlargement of the cervix, which had been replaced by a mass. Induration extended to the parametria and sigmoid colon fat.
Histological examination of endometrial curettage and a cervical biopsy revealed a neoplasm characterized by neoplastic signet-ring cells and trabecular structures. Immunohistochemical analysis and molecular studies showed certain findings consistent with a cervical neoplasm, such as positivity to CEA, keratin 7, Ca-125 and p16 and the presence of HPV (Human Papilloma Virus) DNA 18.
On examination of the hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the lesion replacing the cervix, endometrium and myometrium, revealed the same immunohistochemical findings observed on endometrial curettage and cervical biopsy specimens. Metastases were found in an ovarian cystic lesion and the lymph nodes.
Conclusion
With this report the authors have demonstrated that the spread of cervical adenocarcinoma to the uterine corpus, although rare, may be observed, and that in this instance immunohistochemical and molecular studies can provide sufficient information for accurate diagnosis even on small biopsy specimens.
doi:10.1186/1477-7819-10-7
PMCID: PMC3320546  PMID: 22236794
Signet-ring cell carcinoma; Cervical adenocarcinoma; Human Papilloma Virus (HPV); Polymerase Chain Reaction Amplification (PCR)
3.  Primary malignant lymphoma of the uterus 
Journal of Clinical Pathology  1965;18(6):723-728.
The clinical and pathological findings in a 59-year-old woman with a primary malignant lymphoma of the corpus uteri are described. There was a period of eight months between detection of the uterine lesion and evidence of disease elsewhere in the body. The patient died of disseminated lymphoma, and the distribution of secondary deposits were suggestive of spread via the right ovarian-uterine venous system.
The criteria for acceptance of a diagnosis of primary uterine lymphoma are discussed and the previous literature is reviewed. There have been nine acceptable cases of primary uterine lymphoma recorded: four in the corpus uteri and five in the cervix. The differential diagnosis from stromal sarcoma, anaplastic endometrial adenocarcinoma, leiomyosarcoma, and benign lymphoid hyperplasia is discussed.
Images
PMCID: PMC473118  PMID: 5844198
4.  A case of advanced gynecologic pelvic tumors showing the diagnostic utility of HPV analysis 
Journal of Gynecologic Oncology  2009;20(4):251-253.
Gynecologic malignancies may have similar histological characteristics. This may lead to difficulties in determining the origin of the cancer and to distinguish a synchronous neoplasm from a metastatic cancer in advanced cases. Recently, we treated a 59-year-old patient with adenocarcinoma of the uterine cervix, endometrium, fallopian tubes, and ovaries. It was difficult to determine whether the cancer was a single origin metastatic cancer or a synchronous neoplasm. The patient was finally diagnosed with metastatic cancer that originated from the uterine cervix by human papillomavirus (HPV) test. Here we report the case and briefly review of the medical literature.
doi:10.3802/jgo.2009.20.4.251
PMCID: PMC2799026  PMID: 20041104
Cervical adenocarcinoma; Human papillomavirus; Metastatic cancer; Synchronous neoplasm
5.  Vaginal laparoscopically assisted radical trachelectomy in cervical clear cell adenocarcinoma 
ecancermedicalscience  2013;7:373.
Adenocarcinoma of the cervix is a rare condition that has shown an increase in incidence, especially in the 20- to 34-year-old group. Adenocarcinoma represents about 5–10% of all tumours in this area, and, among these, the clear cell type accounts for 4–9%. This type of tumour affects mainly postmenopausal women but also occurs in young women with a history of prenatal exposure to diethylstilbestrol (DES). The prognosis for adenocarcinoma of the cervix is poor overall and worse for the clear cell variety. This article discusses a case of clear cell adenocarcinoma of the cervix, unrelated to intrauterine exposure to DES, in a woman of childbearing age who wished to preserve her fertility and was therefore treated by radical vaginal trachelectomy and pelvic lymphadenectomy.
doi:10.3332/ecancer.2013.373
PMCID: PMC3826807  PMID: 24244219
clear cell carcinoma; radical trachelectomy; fertility sparing; cervical adenocarcinoma
6.  Pure Basaloid Squamous Cell Carcinoma of the Uterine Cervix: A Case Report 
Journal of Korean Medical Science  2009;24(3):542-545.
Basaloid squamous cell carcinoma of the uterine cervix is an extremely rare malignancy of the female genital tract with a poorer clinical outcome than squamous cell carcinoma of the uterine cervix. We report a case of pure basaloid squamous cell carcinoma of the uterine cervix. A 70-yr-old woman with vaginal bleeding was referred to our institute. A basaloid squamous cell carcinoma of the uterine cervix, of International Federation of Gynecology and Obstetrics (FIGO) stage Ib1, was diagnosed by a loop electrosurgical excision procedure cone biopsy. A radical hysterectomy was performed, along with bilateral salpingo-oophorectomy, pelvic lymph node dissection, and para-aortic lymph node sampling. Pathologic findings were consistent with a basaloid squamous cell carcinoma confined to the cervix without an extracervical tumor. No further treatment was administered and there was no clinical evidence of recurrence during the 12 months of follow-up. Follow-up for the patient is ongoing. Although basaloid squamous cell carcinoma of the uterine cervix is thought to behave aggressively, accumulation of data on these rare tumors is necessary to determine whether their behavior differs significantly from that of conventional cervical squamous cell carcinoma of similar clinical stage. These data would be useful for defining the best diagnosis and treatment for these rare tumors.
doi:10.3346/jkms.2009.24.3.542
PMCID: PMC2698210  PMID: 19543425
Basaloid; Carcinoma, Squamous Cell; Cervix Uteri
7.  Malignant Müllerian Mixed Tumor of the Uterine Cervix with a Small Cell Neuroendocrine Carcinoma Component 
Case Reports in Pathology  2013;2013:630859.
Malignant Müllerian mixed tumors (MMMTs) of the uterine cervix are extremely rare, accounting for 0.005% of all cervical malignancies. To date, only approximately 50 well-documented cases have been reported. Although several epithelial components have been described in cervical MMMTs, small cell neuroendocrine carcinoma (SCC) has not appeared in the English literature. We present a 43-year-old woman, para 2 gravida 2, who had MMMT with SCC and rhabdomyosarcoma components in the uterine cervix. She was referred to our hospital because of a cervical mass with an abnormal Pap smear result. Cervical biopsy revealed SCC. After neoadjuvant chemotherapy with balloon-occluded arterial infusion, she underwent type II radical hysterectomy with pelvic lymphadenectomy. Histological analysis revealed that the cervical tumor comprised SCC and rhabdomyosarcoma components. Genotype analysis indicated human papillomavirus type 18. She underwent concurrent chemoradiation therapy. The patient had been free of the disease and showed no evidence of recurrence 38 months after operation.
doi:10.1155/2013/630859
PMCID: PMC3600347  PMID: 23533892
8.  Advanced small cell carcinoma of the uterine cervix treated by neoadjuvant chemotherapy with irinotecan and cisplatin followed by radical surgery 
Rare Tumors  2011;3(1):e6.
Small cell carcinoma of the uterine cervix is a rare form of cervical cancer characterized by extreme aggressiveness and poor prognosis because of its rapid growth, frequent distant metastases, and resistance to conventional treatment modalities. We report here a case of advanced-stage small cell carcinoma of the uterine cervix treated by neoadjuvant chemotherapy, followed by radical surgery, resulting in locoregional disease control. A 39-year-old Japanese woman was diagnosed as having stage IIIb small cell carcinoma of the uterine cervix. She was treated by neoadjuvant chemotherapy with irinotecan/cisplatin, followed by extended radical hysterectomy with pelvic and paraaortic lymphadenectomy. The patient was further treated by adjuvant chemotherapy with irinotecan/cisplatin. Intrapelvic recurrence has not been detected throughout the postoperative course. However, the patient died with distant metastases of the disease, 27 months following the initial treatment. It has been suggested that neoadjuvant chemotherapy therapy followed by radical surgery is a treatment option for advanced-stage small cell carcinoma of the uterine cervix for the locoregional disease control. Further studies are necessary to obtain information regarding multimodal treatment including sequence, duration, frequency, and type of effective chemotherapy agents to be used in the treatment of small cell carcinoma of the uterine cervix.
doi:10.4081/rt.2011.e6
PMCID: PMC3070456  PMID: 21464879
small cell carcinoma; uterine cervical cancer; neoadjuvant chemotherapy; multimodal therapy.
9.  Primary Uterine Cervix Schwannoma: A Case Report and Review of the Literature 
Case Reports in Pathology  2012;2012:353049.
Schwannoma (neurilemmoma) is a benign peripheral nerve sheath tumor that occurs in a wide variety of locations; however, its finding in the uterine cervix is extremely rare. We report a case of an incidental primary benign cervical schwannoma in a 48-year-old woman. In the English literature, a few cases of primary schwannoma of the cervix have been reported, which include seven cases of primary malignant cervical schwannoma and only two that are benign. These cases are reviewed in the following discussion.
doi:10.1155/2012/353049
PMCID: PMC3539385  PMID: 23320233
10.  Cervical adenocarcinoma presenting as a cardiac tamponade in a 57-year-old woman: a case report 
Introduction
Pericardial effusion as a complication of malignant gynecological disorders is rare. Few cases of endometrial cancer, squamous cell carcinoma of the cervix, ovarian cancer and uterine carcinosarcoma have been previously reported. We report the first case of cardiac tamponade secondary to a cervical adenocarcinoma.
Case presentation
A 54-year-old Caucasian woman, without any relevant medical history and no gynecological aftercare, was admitted to our hospital emergency room with severe dyspnea. Echocardiography revealed severe pericardial effusion with a swinging heart. An emergency pericardial drainage was performed through a pericardial window, which permitted the draining of 700 mL of bloody fluid and a pericardial biopsy. Cytological examination of the fluid revealed atypical cells, and the biopsy specimen showed tumor emboli suggestive of adenocarcinoma. Magnetic resonance imaging showed a 35 mm cervical lesion indicative of an endocervical tumor. Exploratory laparoscopy revealed diffuse peritoneal lesions and histological examination of cervical curettage showed a poorly differentiated micropapillary adenocarcinoma of the cervix.
Conclusion
Carcinomatous pericarditis as the first symptom of a malignant gynecological adenocarcinoma has not, to the best of our knowledge, been documented before. This case highlights the extreme severity of pericardial effusion secondary to cervical adenocarcinoma, a sign of advanced disease. Gynecological malignancies have to be considered in cases of neoplastic pericardial effusion.
doi:10.1186/1752-1947-5-594
PMCID: PMC3259127  PMID: 22188664
11.  Fertility-sparing operation for recurrence of uterine cervical perivascular epithelioid cell tumor 
Rare Tumors  2010;2(2):e26.
Perivascular epithelioid cell tumors (PEComa) are mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelial cells. Although the uterine corpus seems to be one of the most prevalent sites of involvement, PEComa of the uterine cervix are very rare. Only four cervical PEComa cases have been described, and were treated with hysterectomy and radiotherapy.
We report a case of a 24-year-old nulligravida woman who presented with acute abdominal pain and was diagnosed with a rupture of an ovarian chocolate cyst. Subsequent surgery revealed that the tumor arose in the uterus, and the histological diagnosis was uterine PEComa with low potential malignancy. Recurrent PEComa in the uterine cervix were excised twice, and she remains disease free 12 months after the last operation. To the best of our knowledge, this is the first report of recurrent cervical PEComa with fertility-preserving surgery. Estimating the malignant potential and appropriate surgery are essential for young patients with uterine PEComa.
doi:10.4081/rt.2010.e26
PMCID: PMC2994514  PMID: 21139828
perivascular epithelioid cell tumor; PEComa; uterus; cervix; fertility-sparing operation.
12.  Coexistence of early microinvasive endometrioid adenocarcinoma and CIN3 in the uterine cervix in a 32-year-old Japanese woman 
Diagnostic Pathology  2011;6:51.
Simultaneous occurrence of early microinvasive endometrioid adenocarcinoma (EMEA) and CIN 3 in the uterine cervix is very rare in Japan. A 32-year-old Japanese woman was pointed out to have atypical cells in the cervical cytology. Colposcopic examination revealed irregular lesions in the cervix, and a biopsy showed simultaneous EMEA and CIN3. The EMEA was grade I and CIN3 corresponded to severe dysplasia/carcinoma in situ. Hysterectomy and lymph nodes dissection were performed. Grossly, mucosal irregularity and erosion were seen in the cervix. No tumor formation was recognized. The cervix was examined by serial sections. Microscopically, there were a tiny adenocarcinoma (0.5 cm in diameter and 0.3 cm in depth) and broad areas of CIN3. The adenocarcinoma was EMEA without mucins. The EMEA was FIGO stage 1A1. Immunohistochemically, the EMEA was positive for pancytokeratins (AE1/2 +++, CAM5.2 ++), cytokeratin (CK) 34βE12 +, CK5/6 +, CK7 +, CK18 +++, CK19 ++, CA19-9 +, CA125 +++, p53 +, ER +++, PgR +++, while it was negative for CK8, CK14, CK20, EMA, vimentin, CEA, desmin, smooth muscle actin, p63, chromogranin, synaptophysin, CD56, CD68, HER2/neu, MUC1, MUC2, MUC5AC, and MUC6. The CIN 3 was positive for pancytokeratins (AE1/2 +++, CAM5.2 +), cytokeratin (CK) 34βE12 +++, CK5/6 +++, CK7 +, EMA, CA19-9 +, CA125 +, p53 +, p63 +++, ER +++, and MUC1 +, while it was negative for CK8, CK14, CK18, CK19, CK20, vimentin, CEA, desmin, smooth muscle actin, chromogranin, synaptophysin, CD56, CD68, PgR, HER2/neu, MUC2, MUC5AC and MUC6. The lymph nodes showed no metastatic lesions (0/34). In conclusion, the author reported a rare case of simultaneous EMEA and CIN 3 with extensive immunohistochemical findings.
doi:10.1186/1746-1596-6-51
PMCID: PMC3123261  PMID: 21663603
early microinvasive adenocarcinoma; CIN3; uterine cervix; histopathology; immunohistochemistry
13.  Endometrioid Adenocarcinoma Arising from Endometriosis of the Uterine Cervix: A Case Report 
Journal of Korean Medical Science  2009;24(4):767-771.
Endometrioid adenocarcinoma arising from endometriosis of the uterine cervix is rare in premenopausal woman. We describe here a patient with this condition and review the clinical and pathological features of these tumors. A 48-yr-old woman complaining of severe dysmenorrhea was referred for investigation of a pelvic mass. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Histological examination revealed an endometrioid adenocarcinoma directly adjacent to the endometriosis at the uterine cervix, with a transition observed between endometriosis and endometrioid adenocarcinoma. The patient was diagnosed as having endometrioid adenocarcinoma arising from endometriosis of the uterine cervix and underwent postoperative chemotherapy. Gynecologists and pathologists should be aware of the difficulties associated with a delay in diagnosis of endometrioid adenocarcinoma arising from endometriosis when the tumor presents as a benign looking endometrioma.
doi:10.3346/jkms.2009.24.4.767
PMCID: PMC2719211  PMID: 19654969
Carcinoma, Endometrioid; Endometriosis; Cervix Uteri
14.  Perivascular epithelioid cell tumor of the rectum: report of a case and review of the literature 
We report a case of perivascular epithelioid cell tumor arising in the rectum of a 55-year-old woman. The tumor was treated by transanal endoscopic microsurgery. After 1 year follow-up, the patient is alive with no radiologic or endoscopic evidence of recurrence. Perivascular epithelioid cell tumor is a rare mesenchymal tumor characterized by co-expression of melanocytic and smooth muscle markers. This rare tumor can arise in various organs, including the falciform ligament, uterus, uterine cervix, liver, kidney, lung, breast, cardiac septum, pancreas, prostate, thigh, and gastrointestinal tract. Perivascular epithelioid cell tumor of the gastrointestinal tract is very rare, with only 23 previously reported cases. We review the literature on perivascular epithelioid cell tumors arising in the gastrointestinal tract.
doi:10.1186/1477-7819-12-12
PMCID: PMC3896964  PMID: 24410788
Perivascular epithelioid cell tumor; PEComa; Transanal endoscopic microsurgery
15.  Primary Malignant Melanoma of the Uterine Cervix Treated with Ultraradical Surgery: A Case Report 
ISRN Obstetrics and Gynecology  2010;2011:683020.
Primary melanomas of the uterine cervix are rare tumors with no more than 60 cases reported in the world literature. Poor prognosis is considered for the neoplasia itself as well as for diagnostic tardiness. There is no standard treatment; however, radical surgery is the treatment cornerstone. Our aim was to present the case of a 34-year-old woman with a primary malignant melanoma in the uterine cervix with affectation of the posterior face of the vagina without metastasis. Total infraelevator pelvic exenteration and adjuvant radiotherapy was performed. The patient was under surveillance for 8 years of followup without evidence of local or distant disease. The majority of case reports found suggests radical hysterectomy as the treatment indicated for these patients. Notwithstanding this, survival is very short when patients are treated in this manner. Based on our results and on those reported in the literature, we propose initial treatment with total pelvic exenteration as optimal management for this neoplasia in its initial form.
doi:10.5402/2011/683020
PMCID: PMC3101984  PMID: 21654876
16.  Endometrioid adenocarcinoma concurrent with a blue nevus of the endometrium and uterine cervix: A case report 
Oncology Letters  2013;6(5):1219-1221.
A blue nevus is a benign melanocytic lesion that is composed of spindle-shaped pigmented melanocytes. Although the uterine cervix is believed to be the most common extracutaneous location of blue nevi, the occurrence of these lesions in the endometrial stroma has been reported, albeit rarely. The present study describes a case of endometrioid adenocarcinoma concurrent with a blue nevus of the endometrium and uterine cervix. A 58-year-old female presented with abnormal vaginal bleeding. A biopsy from the endometrium revealed an endometrioid adenocarcinoma and subsequently, a total hysterectomy was performed. Histopathological study revealed the proliferation of columnar cells that formed irregularly-shaped tubular and cribriform glands. The neoplastic columnar cells had large, round to oval nuclei containing a single small nucleolus. Focal squamous differentiation was noted. In the stroma of the non-neoplastic endometrium, single or small aggregates of short spindle-shaped cells containing melanin without atypia were observed. These melanocytes were also present in the endocervix. Therefore, the final diagnosis was of endometrioid adenocarcinoma concurrent with a blue nevus of the endometrium and cervix. This is the first documented case of a blue nevus of the endometrium and endocervix. The pathogenesis of blue nevi of the genital tract is not yet completely understood. Possible origins of these cells include Schwann cells or perineural cells of the peripheral nerve fiber or the abnormal migration of neural crest-derived cells.
doi:10.3892/ol.2013.1575
PMCID: PMC3813810  PMID: 24179498
blue nevus; endometrioid adenocarcinoma; endometrium
17.  Advanced papillary serous carcinoma of the uterine cervix: a case with a remarkable response to paclitaxel and carboplatin combination chemotherapy 
Rare Tumors  2011;4(1):e1.
Papillary serous carcinoma of the uterine cervix (PSCC) is a very rare, recently described variant of cervical adenocarcinoma. This review, describes a case of stage IV PSCC whose main tumor existed in the uterine cervix and invaded one third of the inferior part of the anterior and posterior vaginal walls. Furthermore, it had metastasized from the para-aortic lymph nodes to bilateral neck lymph nodes. Immnoreactivity for CA125 was positive, whereas the staining for p53 and WT-1 were negative in both the original tumor and the metastatic lymph nodes. Six cycles of paclitaxel and carboplatin combination chemotherapy were administered and the PSCC dramatically decreased in size. The main tumor of the uterine cervix showed a complete response by magnetic resonance imaging (MRI), and on rebiopsy, more than 95% of the tumor cells in the cervix had microscopically disapperared. This is the first report of PSCC in which combination chemotherapy was used and showed a remarkable response.
doi:10.4081/rt.2012.e1
PMCID: PMC3325736  PMID: 22532907
Papillary serous carcinoma of the uterine cervix; uterine cervical adenocarcinoma; paclitaxel; carboplatin.
18.  Shortened Cervix in the Subsequent Pregnancy after Embolization for Postpartum Cervical Hemorrhage 
Introduction. Rupture of a branch of uterine artery during delivery often leads to a massive postpartum hemorrhage that can be successfully treated using uterine artery embolization. Case Report. A 33-year-old woman had a cesarean section at term followed by a secondary postpartum hemorrhage due to a ruptured cervicovaginal branch terminating in a large, partially thrombosed hematoma of the cervix. She was given selective uterine artery embolization, and she was discharged to home in stable condition on the third day after embolization. In the forthcoming pregnancy a shortened cervix was a risk of threatened premature delivery from 26 weeks of gestation onwards. Conclusion. Superselective unilateral embolization of a thrombosed hematoma in the cervix might prevent extensive iatrogenic trauma of the cervix, which allows preservation of reproductive function.
doi:10.1155/2014/607835
PMCID: PMC3985175  PMID: 24800090
19.  Bilateral ovarian metastatic squamous cell carcinoma arising from the uterine cervix and eluding the Mullerian mucosa 
Diagnostic Pathology  2014;9:109.
Bilateral ovarian metastasis from invasive squamous cell carcinoma of the cervix is a rare phenomenon with very few clinically significant cases described in the literature. Ovarian metastases when present are usually seen in association with bulky, advanced cervical squamous cell carcinomas with extensive involvement of the uterus.
We describe a 48 year old woman with clinically normal cervix whose hysterectomy and bilateral salpingo-oophorectomy performed for abnormal uterine bleeding, demonstrated high grade squamous intraepithelial lesion, moderately differentiated squamous cell carcinoma involving the deeper stroma of the uterus and bilateral ovarian metastases. Gross examination of the cervical canal and the uterine cavity did not show tumor while well circumscribed pearly white metastatic deposits were distinguished within the parenchyma of both the ovaries. Microscopy ascertained high grade squamous intraepithelial lesion with malignant cells invading the deeper cervical stroma and disseminating further as lymphovascular tumor emboli within the myometrium of the corpus uteri without involving the endometrium. Both the fallopian tubes exhibited lymphovascular tumor emboli without epithelial involvement while the parenchyma of both the ovaries showed metastatic deposits.
Although an isolated case of endophytic squamous cell carcinoma of the cervix with extensive lymphovascular invasion of the corpus uteri, both the fallopian tubes and bilateral ovarian deposits without involving either the endometrium or the tubal mucosa does not form a paradigm, this case brings to light the capricious behavior of cervical squamous cell carcinoma.
Virtual Slides
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1214687069122755
doi:10.1186/1746-1596-9-109
PMCID: PMC4071803  PMID: 24899394
Cervical cancer; Endophytic tumor; Bilateral ovarian metastasis; Ovarian squamous cell carcinoma
20.  Bicervical Normal Uterus with Normal Vagina and Anteroposterior Disposition of the Double Cervix 
Case Reports in Medicine  2011;2011:303828.
We report a very uncommon uterine anomaly consisting on a normal uterus, a double cervix with an anteroposterior disposition, and absence of vaginal septum. A 36-years-old woman with one child and absence of past reproductive disorders was examined for a routine checkup. Clinical and transvaginal ultrasound examinations showed a normal uterus with a double cervix disposed in an anteroposterior fashion with the absence of vaginal septum. A review of the theories concerning müllerian fusion is done, and implications of this case in relation with these theories are discussed. This is the first case of a normal uterus with a double cervix situated in an anteroposterior fashion and absence of vaginal septum. This case is in concordance with theories that consider the fusion of the caudal part of Müllerian ducts to be the result of a complex process. It proves that at least in some cases the most caudal part of müllerian ducts is fused in an anteroposterior disposition.
doi:10.1155/2011/303828
PMCID: PMC3138046  PMID: 21776274
21.  Coexisting Malignant Melanoma and Blue Nevus of the Uterine Cervix: An Unusual Combination 
Case Reports in Pathology  2012;2012:986542.
Malignant melanoma (MM) and blue nevi of the uterine cervix are an extremely rare neoplasm, probably derived from embryologic migration of melanocytes from the neural crest. MM displays aggressive behavior with a poor prognosis. We report the case of a 76-year-old postmenopausal woman abnormal vaginal bleeding. She underwent a hysterectomy and bilateral salpingo-oophorectomy with paraaortic-iliac lymphadenectomy. Histopathological and immunohistochemical studies were consistent with the diagnosis of MM and blue nevi in the uterine cervix. Although it is extremely rare, this case suggests that MM of the uterine cervix should be considered in the differential diagnosis of undifferentiated neoplasm. Early diagnosis is essential in order to warrant a better prognosis, although there are no cases of cure described.
doi:10.1155/2012/986542
PMCID: PMC3457599  PMID: 23024873
22.  Myeloid Sarcoma of the Uterine Cervix as Presentation of Acute Myeloid Leukaemia after Treatment with Low-Dose Radioiodine for Thyroid Cancer: A Case Report and Review of the Literature 
Case Reports in Oncology  2009;2(1):1-6.
The development of acute myeloid leukaemia after low-dose radioiodine therapy and its presentation as a myeloid sarcoma of the uterine cervix are both rare events. We report a case of acute myeloid leukaemia revealed by a myeloid sarcoma of the uterine cervix in a 48-year-old woman, 17 months after receiving a total dose of 100 mCi 131I for papillary thyroid cancer. A strict hematological follow-up of patients treated with any dose of 131I is recommended to accurately detect any hematological complications which might have been underestimated. Unusual presentations, such as chloroma of the uterine cervix, may reveal myeloid malignancy and should be kept in mind.
doi:10.1159/000191215
PMCID: PMC2918821  PMID: 20844570
Acute myeloid leukaemia; Myeloid sarcoma of the uterine cervix; Radioiodine therapy
23.  Unusual case of cavitary lung metastasis from squamous cell carcinoma of the uterine cervix 
Spontaneous excavation of primary lung cancer is common; however cavitation of metastatic lung lesions is rare and usually confused with benign lesions. In Moroccan context tuberculosis is the first suspected diagnosis of lung excavations. We report a rare case of cavitary lung metastasis of a uterine cervix cancer, treated initially as tuberculosis. A 40-year old non-smoking woman with a known history of squamous cell carcinoma of the uterine cervix since August 2005; presented on September 2008 with right chest pain without fever, hemoptysis or weight loss. CT scan showed a thin walled cavity. Empirical Antibiotic therapy was conducted 15 days with poor outcome. Then antibacillary treatment was started with no proof of mycobacterial infection. A month later, the patient presented with gynecological bleeding and a pneumothorax. Bronchoscopy with transbronchial biopsy of the cavitary mass was performed. Pathology demonstrated a metastatic squamous cell carcinoma. Pelvic examination and MRI showed a subsequent local cervix recurrence. Patient underwent 3 courses of systemic chemotherapy. She died on June 2009 due to progressive disease. Even cavitary lung metastases are rare and benign differential diagnosis are more common, clinician should be careful in neoplastic context and investigation should be done to eliminate a recurrence.
doi:10.11604/pamj.2013.14.37.1420
PMCID: PMC3612870  PMID: 23560120
cavitary lung metastasis; squamous cell carcinoma; uterine cervix
24.  Papillary serous carcinoma of the cervix mixed with squamous cells: A report of the first case☆ 
Objective
Primary papillary serous carcinoma (PPSC) of the cervix is rarely recognized, with the aggressive and unpredictable course. Here we report a case of primary adenosquamous papillary serous carcinoma of the cervix in a woman who underwent comprehensive treatment.
Case
A 53-year-old woman presented with irregular vaginal bleeding in hospital. The patient with a diagnosis of PPSC by an intracolposcopic biopsy received radical hysterectomy with bilateral salpingo-oophorectomy, right pelvic lymphadenectomy, left pelvic lymph node dissection, and postoperative concurrent chemoradiotherapy. Postoperative immunohistochemistry showed that CK5/6, CK7, P16, CEA, CA12-5 and P53 were positive. During 17 months after operation, the patient demonstrated distant metastases of lymph nodes and finally died of brain metastasis.
Conclusions
Papillary serous adenocarcinoma of the cervix mixed with squamous cell carcinoma has not been reported since now, and here, this is the first documented case. Despite surgery and concurrent chemoradiotherapy, which were reported as effective therapeutic strategies for papillary serous adenocarcinoma of the cervix, the patient showed a poorer prognosis. Taken together, papillary serous adenosquamous carcinoma of the cervix could be more malignant than pure papillary serous adenocarcinoma.
Highlights
•Papillary serous adenosquamous carcinoma of the cervix is firstly documented here.•Surgery and postoperative chemoradiotherapy showed a poorer prognosis in the patient.•Mixed adenosquamous carcinoma of the cervix behaves more aggressively .
doi:10.1016/j.gynor.2013.07.003
PMCID: PMC3862309  PMID: 24371711
PPSC, Primary papillary serous carcinoma; CEA, carcinoembryonic antigen; SCC, squamous cell carcinoma; CA, cancer antigen; MRI, magnetic resonance imaging; CT, computed tomography; AC, adenocarcinoma; Papillary serous carcinoma of the cervix; Adenosquamous carcinoma; Therapy
25.  Xanthogranulomatous Salpingitis Associated with a Large Uterine Leiomyoma 
Case Reports in Medicine  2010;2010:970805.
A case of xanthogranulomatous salpingitis (XGS) associated with a large uterine leiomyoma in a 50-year-old woman is presented. Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to affected organs. It is characterized by the presence of lipid-filled macrophages with admixed lymphocytes, plasma cells, and neutrophils. A review of the literature revealed that most patients with XGS have a clinical history of long-standing pelvic inflammatory disease (PID) or, less often, endometriosis. We report a case lacking a history of either PID or endometriosis but with a concurrent large uterine leiomyoma. Although the exact etiology in this case was not clear, the leiomyoma may have played a contributory role in pathogenesis.
doi:10.1155/2010/970805
PMCID: PMC2963120  PMID: 20981281

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