Introduction/Background Squamous cell carcinoma (SCC) of the cervix is the most common type of cervical cancer. It generally invades the endometrial cavity directly with or without parametrium involvement however, in rare cases can develop a superficial spread to the inner surface of the uterus replacing the endometrium. It is an unusual phenomenon for cervical carcinoma in situ to have continuous superficial extension to the endometrium without endometrial involvement.
Methodology We report a case of a 69 year old female, 19 year post-menopausal, who attended the Gynecologic Department for malignant squamous cells found on her routine cervical smear. The conization biopsy which performed revealed cervical intraepithelial neoplasia III (CIN III) and the patient underwent a hysterectomy with bilateral salpingo-oophorectomy. The final histological examination confirmed the diagnosis of CIN III, non-keratinizing, of small cell type. Cervix and endocervix consisted entirely of CIN III extending up to the endometrial cavity. Both endometrial glands and stroma were completely replaced by CIN III, with involvement of foci of adenomyosis. Immunohistochemical staining for PAS showed that the basement membrane was intact and the cells were positive for p16.
Results The histology and immunochemistry of the cervical neoplasia were compatible with CIN III with contiguous and superficial intraepithelial extension to the endocervix and the endometrium.
Conclusion The superficial intraepithelial extension of squamous cell carcinoma in situ of the cervix is very rare and guidelines for the management of these cases are lacking. We treated our patient with simple hysterectomy and did not show any evidence of recurrence 7 months of follow up.
Disclosure Nothing to disclose.
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