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Superficial Spreading, Microinvasive CIN 3 of Cervix: Report of an Unusual Pattern of Endometrial Involvement

Abstract

Microinvasive squamous cell carcinoma (SCC) of the cervix is labeled by the lower anogenital squamous terminology as superficial invasive squamous cell carcinoma (SISCCA). This currently conforms to the T1a1/FIGO IA1 stage, which is defined with a stromal invasion of less than 3 mm in depth (Darragh et al. in Arch Pathol Lab Med 136(10):1266–1297, 2012). Under rare circumstances, these carcinomas can spread laterally to involve the endometrium, which increases the tumor volume and is a significant predictor of outcome. We present a case report of a 60-year-old post-menopausal woman who presented with persistent bleeding and absence of an overt cervical mass on magnetic resonance imaging. She underwent a Wertheim’s hysterectomy, and on pathological examination, the cervix revealed a diffuse CIN 3 (Cervical Intraepithelial Neoplasia) with focal microinvasion. In addition, there was extensive superficial spread to the entire endometrium along with focal invasion and lymphovascular space invasion. This presentation is extremely rare, with less than 50 cases reported worldwide (Bagde et al. in J Fam Med Prim Care 10(9):3505, 2021).

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References

  1. Darragh TM, Colgan TJ, Cox JT, et al. The lower anogenital squamous terminology standardization project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Arch Pathol Lab Med. 2012;136(10):1266–97.

    Article  Google Scholar 

  2. Bagde MN, Bagde NKD, Hussain N, et al. A review and case report of enigmatic superficial endometrial spread of cancer of the uterine cervix: Need for vigilance in the primary care setting. J Fam Med Prim Care. 2021;10(9):3505.

    Article  Google Scholar 

  3. Krishnamurti U, Movahedi-Lankarani S, Bell D, et al. Protocol for the examination of specimens from patients with primary carcinoma of the uterine cervix. College of American Pathologists. 2017.

  4. Du J, Liao X. Superficial spreading squamous cell carcinoma in situ of the cervix involving the endometrium: a rare case presentation and review of literature. Int J Clin Exp Pathol. 2019;12(11):4162.

    PubMed  PubMed Central  Google Scholar 

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The authors received no specific funding for this study.

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Correspondence to Meenakshi Rao.

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The authors declare that they have no conflict of interest.

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This case report was approved by the Department of Pathology, All India Institute of Medical Sciences, Jodhpur.

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Khalid A. Mannan is an MD, DipRCPath, Senior resident, Department of Pathology and Lab Medicine, AIIMS, Jodhpur, Jodhpur, India; Meenakshi Rao is an MD, Associate Professor, Department of Pathology and Lab Medicine, AIIMS, Jodhpur, Jodhpur, India; Garima Yadav is an Associate Professor, Department of Obstetrics and Gynaecology, AIIMS, Jodhpur, Jodhpur, India; Taruna Yadav is an Associate Professor, Department of Diagnostic and Interventional Radiology, AIIMS, Jodhpur, Jodhpur, India.

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Mannan, K.A., Rao, M., Yadav, G. et al. Superficial Spreading, Microinvasive CIN 3 of Cervix: Report of an Unusual Pattern of Endometrial Involvement. J Obstet Gynecol India (2022). https://doi.org/10.1007/s13224-022-01667-2

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  • DOI: https://doi.org/10.1007/s13224-022-01667-2

Keywords

  • CIN 3 cervix
  • CIN 3 endometrium
  • Superficial spreading SCC
  • Microinvasive SCC