European Journal of Biomedical and Pharmaceutical Sciences

SCC CERVIX OF ISTHIMUS EXTENDING INTO ENDOMETRIUM MIMICKING SQUAMOUS MORULE IN ENDOMETRIAL CARCINOMA IN SITU

Nirupma Lal*, Neema Tiwari, Parul Gupta, Ramis Khan, Osman Musa

ABSTRACT

Carcinoma cervix is one of the most common causes of post menopausal bleeding and shows a strong correlation with HPV infections. It is the most common gynecological malignancy in India. Recognized patterns of the local tumor spread include direct invasion of the parametrium and endometrial cavity, but a superficial upward spread without invasion of the underlying myometrium is uncommon[1] A common differential to carcinoma cervix extending into the uterus is the Squamous differentiation/squamous metaplasia often associated with endometrial adenocarcinoma and benign lesions, such as endometrial hyperplasia and chronic endometritis. These squmaous morules have distinct histological characteristics, and are referred to as squamous metaplasia or squamoid metaplasia.[2] Another entity that should be discussed here is the double malignancies of uterus and cervix co existing. Synchronous double cancer was defined as additional cancer developing within 6 months of the first cancer and metachronous double cancer was defined as additional cancer developing after an interval of 6 months or longer.[3] We report an interesting cases of squamous cell carcinoma of the cervix in the isthmus extending upwards into the endometrium with moderate cervical stenosis resulting in pyometra, which mimicked a focal islands of epithelial squamous morule with surrounding glands showing reactive atypia due to intense inflammation which mimicked a Endometrial In-situ Neoplasia. This is a very rare phenomenon, with fewer than 30 cases reported so far in the literature hence this case report is important in highlighting the mimickers as well as a possibility of double malignancy in such type of tumors.[4]

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