Primary squamous cell carcinoma of endometrium-a rare presentation

Abstract

Primary endometrial squamous cell carcinoma is an extremely rare tumor with unclear pathogenesis. We report a case of 55-year-old postmenopausal woman who presented with abdominal distention and bloodstained vaginal discharge for 9 months. Clinically, chronic pyometra was considered. Total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed and histopathological examination revealed a diagnosis of primary endometrial invasive squamous cell carcinoma with associated complete squamous cell metaplasia of glandular endometrium and coexisting multifocal squamous cell dysplasia, without involvement of the uterine cervix. The tumoral cells showed to be p16 negative and strongly p53 positive.

Molecular Analysis of HPV-independent Primary Endometrial Squamous Cell Carcinoma Reveals TP53 and CDKN2A Comutations

“…This is similar to the results of this study, where ER and PR were negative in all cases. An aberrant p53 expression pattern was identified in at least 4 of 21 (19%) reported cases 5,7–10,18. Before the recommendations for p53 immunohistochemical reporting in endometrial carcinomas were established,22,23 some reported HPV-independent PESCCs were described as p53 “positive” or “negative.” However, it is challenging to determine if cases reported as “positive” represent an aberrant/mutation-type pattern with diffuse nuclear overexpression, an aberrant cytoplasmic staining pattern, or a normal/wild-type pattern when the specific details of p53 immunostaining interpretation are not provided, as is the situation in 2 of 21 (10%) prior cases.…”

“…A total of 28 cases was identified in 14 studies (Table 4). 4,5,[7][8][9][10][11][12][13][14][15][16][17][18] The median age at diagnosis was 62 years, which is slightly younger than the women in our study (mean and median, 78 y). The majority of cases were negative for ER and PR in 19/23 (82.6%) and 19/22 (86.4%) cases, respectively.…”

“…An aberrant p53 expression pattern was identified in at least 4 of 21 (19%) reported cases. 5,[7][8][9][10]18 Before the recommendations for p53 immunohistochemical reporting in endometrial carcinomas were established, 22,23 some reported HPVindependent PESCCs were described as p53 "positive" or "negative." However, it is challenging to determine if cases reported as "positive" represent an aberrant/mutation-type pattern with diffuse nuclear overexpression, an aberrant The clinicopathologic and molecular results reported herein are similar to what has been described in SCCs arising in other locations in the lower gynecologic tract.…”

“…The pathogenesis of PESCC is not well understood, and both human papillomavirus (HPV)-associated [4][5][6] and HPV-independent 4,5,[7][8][9][10][11][12][13][14][15][16][17][18] tumors have been described. For HPV-independent tumors, nulliparity, pyometra, and ichthyosis uteri have been implicated as associated conditions.…”

Micro-invasive Primary Squamous Cell Carcinoma of Endometrium: Case Report, 2023

“…Pure primary endometrial squamous cell carcinomas (PESCC) are extremely rare, accounting for 1% of all malignancies of the corpus uteri with only 100 cases being reported in the literature, since the first report in 1892 by Gebhard [1,2]. It is usually seen in postmenopausal women and associated with cervical stenosis, pyometra, chronic inflammation, nulliparity and icthyosis uteri.…”