Abstract
Background : Primary squamous cell carcinoma of the endometrium is rare and is usually at an advanced stage even at diagnosis. Herein, we report a case of endometrial squamous cell carcinoma that was diagnosed by repeated endometrial cytology.
Case : A 72-year-old woman visited our hospital complaining of vaginal discharge. Ultrasonography and MRI revealed no hyperplastic endometrial lesions. Cervical cytology showed slightly atypical squamous cells and endometrial cytology showed normal atrophic endometrium with atypical squamous cells. Colposcopy showed unsatisfactory colposcopic findings and endometrial biopsy revealed atypical squamous cells ; therefore, we determined that the origin of the specimen was the uterine cervix and made the diagnosis of CIN1. The cytologic features of the cervix and endometrium changed to squamous cell carcinoma-like, therefore, conization was performed using a harmonic scalpel. Histological examination of the conization biopsy specimen did not reveal any carcinoma or atypical cells. After conization, the abnormal endometrial cytology findings persisted, therefore, hysterectomy was performed. Based on histopathological examination of the resected specimen?, the patient was diagnosed as having stage 1a endometrial squamous cell carcinoma.
Conclusion : When atypical squamous cells are observed on endometrial cytology, endometrial squamous cell carcinoma should be considered in the differential diagnosis.
