Simultaneous malignant squamous metaplasia of the cervix and ovary

Synchronous ovarian and cervical squamous intraepithelial neoplasia: an analysis of HPV status

In contrast to the strong association between human papillomavirus (HPV) and cervical intraepithelial neoplasia (CIN), the relationship between HPV and squamous epithelial lesions of the ovary is less clear. We report a case of synchronous ovarian and cervical squamous intraepithelial neoplasia. To investigate the possible association between HPV and squamous intraepithelial neoplasia/carcinoma in situ (CIS) of the ovary, DNA was extracted from paraffin-embedded tissues including normal cervix, CIN, CIS from both ovaries, and an area of ovarian endometriosis. All samples were positive for HPV 16 E6 except for one of the two samples from the normal cervical squamous epithelium. These results support the hypothesis that HPV may be involved in the development of ovarian squamous intraepithelial neoplasia.

Primary squamous cell carcinoma of the ovary. Report of 37 cases

A total of 37 cases of ovarian primary squamous cell carcinoma (SCC)-19 associated with a dermoid cyst (SCCD), seven associated with endometriosis (SCCE), and 11 pure (SCCP)-are described. The last 18 cases belong within the new World Health Organization category of SCC in the surface epithelial-stromal category. The 19 patients with SCCD were 21-75 (mean, 52) years old; three of the carcinomas were in situ and seven, six, and three tumors were stages I, II, and III, respectively. The tumors and associated dermoid cysts were 6-35 cm in greatest dimension, usually forming mural nodules with intracavitary protrusion and focal necrosis and hemorrhage; two, seven, and seven tumors were grades 1, 2, and 3, respectively. SCCD was focally associated with a columnar epithelial cyst lining in 13 cases, suggesting an origin therein. One patient with stage I, grade 1 SCCD also had squamous cell carcinoma in situ (CIS) of the cervix. The seven patients with SCCE were 29-70 (mean, 49) years old, and one, three, one, and two tumors were stages I, II, III, and IV, respectively; all of the tumors were grade 3. One was associated with squamous cell carcinoma in situ of the cervix. The 11 patients with SCCP were 27-73 (mean, 56) years old, and one, four, five, and one tumors were stages I, II, III, and IV, respectively. The tumors were 6-26 cm in greatest diameter, usually solid with focal necrosis; one and 10 tumors were grades 2 and 3, respectively. Three patients with SCCP also had cervical squamous cell carcinoma in situ. The patients with SCCE had a poorer overall survival than those with SCCD. Five of the six patients with SCCE for whom adequate follow-up information was available died of their disease (mean survival, 5 months); also, in all five cases of SCCE reported in the literature, the patients died of their disease (mean survival, 4 months). The stage of the tumor and its grade correlated best with overall survival for all three types of SCC.

Bilateral primary ovarian squamous cell carcinoma associated with human papilloma virus infection and vulvar and cervical intraepithelial neoplasia. A case report with review of the literature

Primary squamous cell carcinoma of the ovary is rare. Most cases represent malignant transformation of ovarian teratomas. Other cases are associated with preexisting Brenner tumor or ovarian endometriosis. We report a primary ovarian squamous cell carcinoma in a 40-year-old woman. The patient had recurrent high-grade intraepithelial neoplasia of the vulva (VIN) and recurrent high-grade cervical intraepithelial neoplasia (CIN). Human papilloma virus (HPV) DNA 16/18 was identified in an in situ and invasive carcinoma in the left ovary; CIN and VIN were identified with in situ hybridization with biotinylated DNA probes. Review of the literature revealed nine cases of primary ovarian squamous cell carcinoma not associated with a preexisting ovarian lesion. Three cases were not associated with CIN and occurred in women who ranged in age from 64 to 90 years and did not have carcinoma in situ component. Six cases were associated with CIN, had a carcinoma in situ, and occurred in younger women ranging from 33 to 54 of age. Our case belonged to the latter category. This report raises the possible causal relationship of HPV with primary ovarian squamous carcinoma in the group of middle-aged patients with CIN.

Squamous intraepithelial neoplasia in an ovarian cyst, cervical intraepithelial neoplasia, and human papillomavirus

A case of squamous intraepithelial neoplasia in an ovarian cyst in association with cervical intraepithelial neoplasia (CIN) III is described. In view of the association of human papillomavirus (HPV) and CIN, the possibility that HPV infection could be associated with similar changes in the ovary was postulated. The HPV genome was shown in formalin-fixed tissue of the cervical lesion by nonisotopic in situ hybridization (NISH) and by the polymerase chain reaction (PCR). However, HPV could not be shown in the ovarian lesion by NISH or PCR. On the basis of these findings there appears to be no association between HPV infection and squamous intraepithelial neoplasia in an ovarian cyst.

Primary squamous carcinoma of the ovary: a case report and review of the literature

Only three cases of primary squamous carcinoma of the ovary have been reported to date. This fourth case serves to illustrate similarities between all known cases of this tumor. This tumor presents primarily as a simple cyst or has a major cystic component. Three of the reported cases (including the present one) had a prior diagnosis of carcinoma in situ of the uterine cervix. Accurate surgical staging and complete tumor excision appear to be optimal therapy for squamous carcinoma of the ovary.

Pure primary ovarian squamous cell carcinoma

A 65-year-old woman with pure primary ovarian squamous cell carcinoma invading the fallopian tube and the terminal ileum is described. The tumor recurred shortly after surgery in spite of complete resection. No response to chemotherapy was observed and the patient expired 6 months after diagnosis. In order to establish the diagnosis of pure primary ovarian squamous cell carcinoma extragenital and genital tumors containing squamous elements as well as endometriosis have to be excluded.

Primary squamous ovarian carcinoma. A case report and review of the literature

A case of pure primary squamous cell carcinoma of the ovary is presented and the literature is reviewed. Unlike both previously reported cases, this case was not associated with antecedant carcinoma of the cervix. Possible origins of squamous ovarian neoplasm are discussed.