Abstract
Background : Cervical squamous cell carcinoma (SCC) spreading to the upper genital tract is very rare. We report the case of a patient with cervical SCC extending to the endometrium and fallopian tubes who was treated by radical hysterectomy based on intraoperative cytologic diagnosis.
Case : A gravida 1, para 1, postmenopausal woman in her 50 s, 2 years post-conization for cervical intraepithelial neoplasia (CIN), presented with an abdominal mass and pain. Although magnetic resonance imaging (MRI) revealed a cervical mass that was suspected as being malignant and pyometra, preoperative pathological diagnosis by cervical biopsy failed because of cervical stenosis. Intraoperative exploration revealed bilateral pyosalpinx and pyometra, and cervical SCC was diagnosed by positive intraoperative fallopian tube fluid cytology. Radical hysterectomy was performed based on the positive cytology, followed by pelvic lymphadenectomy based on frozen section diagnosis of the cervix. Histologically, the SCC was found to invade almost the entire cervix, and extended to the endometrium of the uterine body and epithelium of the fallopian tubes of both sides.
Conclusion : A radical hysterectomy with pelvic lymphadenectomy was performed successfully, based on diagnosis by intraoperative cytology, in a rare case of cervical SCC spreading to the endometrium and fallopian tubes.
