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


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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Correspondence to Meenakshi Rao.

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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).

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