Papillary squamotransitional carcinoma of cervix: a series of four cases

Abstract

INTRODUCTIONCarcinoma of cervix is the most common cancer in Indian women and squamous cell carcinoma is the principal histological type. Papillary squamo-transitional carcinoma is a rare and distinctive variant of squamous cell carcinoma of the uterine cervix, which differs by histology and clinical behaviour from conventional squamous cell carcinoma.1 Papillary squamo-transitional cell carcinoma can show variety of spectrum such as pure squamous, pure transitional and mixture of both.2 It shows papillary architecture with fibrovascular cores lined by multi-layered atypical epithelium and is known for local recurrence and late metastasis. METHODS4 cases of papillary squamo-transitional carcinoma of uterine cervix were diagnosed on cervical punch biopsies received in Department of Pathology over a period of one year. All the biopsies were processed by routine paraffin processing and stained with haematoxylin and eosin stain. RESULTSMean age among the 4 cases was 52 years with age ranging from 40 years to 70 years. The presenting symptoms were Pain in abdomen (all 4 cases), P/V bleeding (2 cases) and P/V discharge (2 cases). Per speculum examination in all cases revealed an ulcerated growth in uterine cervix. All the cases were subjected to cervical punch biopsy. ABSTRACTBackground: Carcinoma of cervix is the most common cancer in Indian women and squamous cell carcinoma is the principal histologic type. Papillary Squamotransitional carcinoma is a rare and distinctive variant of squamous cell carcinoma of the uterine cervix, which differs by histology and clinical behavior from conventional squamous cell carcinoma. It shows papillary architecture with fibrovascular cores lined by multilayered atypical epithelium and is known for local recurrence and late metastasis. Methods: 4 cases of papillary squamotransitional carcinoma of cervix were diagnosed on cervical punch biopsies. All 4 cases were analyzed histopathologically. Results: Patients ranged from 40 years to 70 years with pain in abdomen being commonest presenting symptom. All the cases showed papillary architecture with fibrovascular cores lined by multi-layered atypical epithelium. Three cell types were observed: Clear, intermediate and basaloid. Conclusions: Papillary Squamous Cell Carcinoma is a rare subtype of squamous cell carcinoma of cervix and is characterized by its aggressive behavior.

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

“… 1 , 6 , 9 Cytokeratin profiles of PSTCC have a CK7+/CK20− pattern. 10 This case should raise physicians' awareness of PSTCC and they should always consider it in postmenopausal women with postcoital bleeding, especially when the histology shows transitional cancer (CK7+ and CK20−). Also, consider hematuria or urinary symptoms in the presence of the transitional pattern.…”

“…However, in reports, stromal invasion alters between 55% and 65% 1,6,9 . Cytokeratin profiles of PSTCC have a CK7+/CK20− pattern 10 . This case should raise physicians' awareness of PSTCC and they should always consider it in postmenopausal women with postcoital bleeding, especially when the histology shows transitional cancer (CK7+ and CK20−).…”

Papillary Squamo-Transitional Cell Carcinoma

“…The review of literature shows that initially PSTCC was thought to be biologically like SCC depending upon the predominant histopathologic feature. Koenig et al studied 32 patients diagnosed with PSTCC [7]. They divided papillary squamo-transitional cell carcinoma into 3 groups depending upon predominant histologic featurepredominantly squamous (28.1%), mixed squamous and transitional (50%), and transitional (21.9%).…”