Poorly differentiated squamous cell carcinoma of the cervix with sarcomatoid differentiation: Report of a case with cytohistological correlation

Abstract

Sarcomatoid squamous cell carcinoma (SSCC) of the uterine cervix is a rare malignancy with uncertain pathogenesis and aggressive clinical behavior. The diagnosis of this tumor poses a challenge to the cytopathologist since accurate diagnosis is based on identification of two malignant components, that is, epithelial and sarcomatoid. Most cases usually lack the sarcomatoid component on Papanicolaou test (Pap test). Therefore, a poorly differentiated carcinoma or malignant neoplasm is the most often rendered diagnosis. To date, less than 20 cases have been reported. Most of these cases were diagnosed by histopathologic findings. To our knowledge, cytomorphologic findings of SSCC on a liquid-based Pap test, with utility of cell block sections, in recognition of the two components of tumor, with follow-up histopathologic correlation have not been described. A case of SSCC occurring in a 57-year-old postmenopausal woman, describing the cytologic features on a liquid-based Pap-test, histopathologic findings of subsequent cervical biopsy, differential diagnosis, and role of ancillary studies are illustrated and discussed. Diagn. Cytopathol. 2017;45:137-142. © 2016 Wiley Periodicals, Inc.

Chondrosarcoma‐like metastasis from a poorly differentiated uterine cervical squamous cell carcinoma. A unique morphology and diagnostic pitfall in cytology

“…While sarcomatoid differentiation of squamous cell carcinoma in the head and neck literature is common, it is extremely rare in the cervix . The seemingly unusual differentiation pattern sometimes exhibited by metastatic squamous cell carcinoma from the cervix may be related to the microenvironment underlying the transformation zone.…”

“…(3) A malignant clone induces an atypical but benign connective tissue reaction 5. However, the latter theory is unlikely because sarcomatous component metastasizes and is morphologically malignant.While sarcomatoid differentiation of squamous cell carcinoma in the head and neck literature is common, it is extremely rare in the cervix 6. The seemingly unusual differentiation pattern sometimes exhibited by metastatic squamous cell carcinoma from the cervix may be related to the microenvironment underlying the transformation zone.This area is thought to play an important role in determining the degree of differentiation in the cervical carcinogenesis.…”