Thin-layer (liquid-based) cytologic findings of papillary squamotransitional cell carcinoma of the cervix. Review of cases over a 4-year period with emphasis on potential diagnostic pitfalls

Papillary squamotransitional cell carcinoma of the uterine cervix: A rare case report

Key Clinical Message

Although papillary squamotransitional cell carcinoma is an uncommon variant of cervical squamous cell carcinoma, due to the complex papillary structure and the challenge in detecting stromal invasion, its timely diagnosis and treatment are very important.

Abstract

Papillary squamotransitional cell carcinoma (PSTCC) is extremely rare and presents with a spectrum of morphologies. PSTCC may present as an in situ tumor with or without an invasion, but usually, it displays both features. Here we report a 60-year-old woman, diagnosed with PSTCC of the uterine cervix.

Papillary Squamotransitional Cell Carcinoma of the Uterine Cervix: A Case Report and Review of the Literature

Introduction. Papillary squamotransitional cell carcinoma (PSTCC) is an uncommon histopathological variant of squamous cell carcinoma (SCC) of the uterine cervix, which occurs in postmenopausal women. Presentation of Case. Herein, we describe a case of a 63-year-old woman who presented with 4-month history of postmenopausal vaginal bleeding. Vaginal examination revealed a fragile lesion of size 1 × 1 cm invading left posterior vaginal fornice and parametrium. Biopsy showed the presence of papillae containing fibrovascular cores lined by multilayered atypical epithelial cells resembling squamous and transitional cell epithelium, confirming the diagnosis of PSTCC of the uterine cervix. After staging work-up she was staged according to the International Federation of Gynecology and Obstetrics (FIGO) staging system 2009 as FIGO IIB, and she was started on extended field concurrent chemoradiation. Discussion. PSTCC of the uterine cervix is an extremely rare and aggressive entity. PSTCC is often characterized by the presence of papillary structures with prominent fibrovascular cores. PSTCC of the uterine cervix should be differentiated from transitional cell carcinoma, squamous papilloma, papillary adenocarcinoma, and cervical intraepithelial neoplasia with papillary features. Conclusion. PSTCC of the uterine cervix is a diagnostic challenge; further studies regarding the mechanism underlying the development of PSCC are warranted.

Papillary squamotransitional cell carcinoma of the vagina

A case of a papillary squamotransitional cell carcinoma (PSTCC) of the vagina with a follow-up of 3 years is presented here. The characteristics of this case support a squamous rather than urothelial origin of this rare entity. Unlike its counterparts in the cervix uteri, the clinical behavior of vaginal PSTCC is more favorable than squamous cell carcinoma. Histological and clinical features are compared to those of previously described cases of vaginal and cervical PSTCC.

Papillary squamous cell carcinoma of the cervix in Uganda: a report of 20 cases

BACKGROUND

Non-glandular papillary carcinoma of the cervix are uncommon tumours. In Uganda where cervical carcinoma is very common, no cases of papillary squamous cell carcinoma of the cervix has been reported.

OBJECTIVES

To ascertain the occurrence and describe the clinicopathological features of papillary squamous cell carcinoma of the cervix in Uganda.

STUDY DESIGN

Retrospective review of histologically diagnosed cases of squamous cell carcinoma of cervix with papillary structures.

METHODS

Retrospective review of cases of cervical carcinoma diagnosed in the Pathology Department, Makerere University from 1968 to 1973 was done. Cases with features of squamous differentiation and forming papillary pattern were then selected.

RESULTS

Twenty cases were encountered and the ages of the patients ranged from 22 to 70 years (mean 46.6 years). Histologically, the tumours had thin to broad fibrovascular cores covered by multilayered squamous epithelium. In five cases, there were areas with very delicate fibrovascular cores covered by monolayered epithelial cells.

CONCLUSION

The results of this study show that in Uganda, papillary squamous cell carcinoma of the cervix does occur and is predominantly a disease of older women. The results also confirm that papillary squamous cell carcinoma is a distinct subtype with some variants, and support the hypothesis that squamous cell carcinoma of the cervix is heterogeneous group of tumuors.