Metastatic breast cancer diagnosed on cervical cytology

Abstract

An unusual case is described of a 64‐year‐old woman with a remote history of breast cancer whose first non‐nodal metastasis was discovered on a routine Pap test. The Pap test was supported by the results of cervical and endometrial biopsies.

Smear detected cervicovaginal melanoma following negative screening—a cautionary tale of rapidly developing malignancy of the lower female genital tract

“…Examples of HPV-independent malignant lesions that may escape detection by routine screening include metastatic carcinomas, carcinoma cells shed from the urinary bladder and upper female genital tract, and local spread from pelvic (mostly colorectal and genitourinary) carcinomas. [5][6][7] These lesions can develop rapidly within screening intervals, and similar to our case, show no HPV-related effects or lesions in the background. Furthermore, primary HPVindependent malignancies, such as melanomas and lymphomas, 4,9 can be locally limited and clinically unnoticed, inappropriately implying an even lower index of suspicion for malignancy.…”

“…Examples of HPV‐independent malignant lesions that may escape detection by routine screening include metastatic carcinomas, carcinoma cells shed from the urinary bladder and upper female genital tract, and local spread from pelvic (mostly colorectal and genitourinary) carcinomas 5‐7 . These lesions can develop rapidly within screening intervals, and similar to our case, show no HPV‐related effects or lesions in the background.…”

“…The description and reporting of HPV (human papilloma virus)‐related epithelial changes and lesions are well described, 2 and show the best interobserver agreement in the negative for intraepithelial lesion (NILM), low‐grade squamous intraepithelial lesion (LSIL), high‐grade squamous intraepithelial lesion (HSIL), and squamous cell carcinoma (SCC) diagnostic categories 3 . Primary malignant mesenchymal tumours of the cervix, 4 carcinoma shed from the urinary bladder 5 and uterine corpus, 6 as well as metastatic carcinomas 7 can also be found on cervical Pap smears. These HPV‐independent lesions are often variable in clinical presentation and difficult to diagnose and/or categorise cytologically 3 .…”

Invasive Ductal Breast Carcinoma Metastasis to the Uterine Cervix Presenting As Heavy Vaginal Bleeding: A Case Report and a Literature Review

“…A concise literature review of reported cases of breast cancer metastases to the cervix, adapted from Horikawa et al and Proença et al, revealed a total of 19 cases [17,18]. In this literature review (Table 1), of the 19 patients -including our case -there was an almost equal distribution of invasive lobular carcinoma and invasive ductal carcinoma, 11 and 8 cases, respectively [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. This review demonstrated that presenting symptom leading to the discovery of metastasis to the cervix was abnormal vaginal bleeding in 12 out of 19 patients.…”

“…A concise literature review of reported cases of breast cancer metastases to the cervix, adapted from Horikawa et al and Proença et al, revealed a total of 19 cases [ 17 , 18 ]. In this literature review (Table 1 ), of the 19 patients - including our case - there was an almost equal distribution of invasive lobular carcinoma and invasive ductal carcinoma, 11 and 8 cases, respectively [ 17 - 32 ].…”