Abstract
BackgroundPapillary squamous cell carcinoma (PSCC) of the uterine cervix is difficult to diagnose due to its rarity and limited data regarding its clinical behavior. We attempted to assess the degree of stromal invasion using magnetic resonance imaging (MRI) and evaluate possible treatments for this lesion in view of its clinical behavior.MethodsWe analyzed 28 cases of PSCC diagnosed on the colposcopic selective biopsies. We studied the rate of accuracy of diagnoses of the colposcopic selective biopsies compared with the final diagnoses, and compared the rate of stromal invasion between the MRI and pathological findings while focusing on surgical methods and the clinical prognosis.ResultsOf the 28 patients, only 12 exhibited true PSCC. The other 16 patients were ultimately diagnosed with SCC or adenosquamous carcinoma based on the finding of the surgical specimens and exhibited relatively poor prognoses. Among the 12 true PSCC cases, the rate of diagnostic accuracy of stromal invasion (with or without) was only 58% (7/12) on the colposcopic selective biopsies. However, we were able to predict the presence of stromal invasion (microscopic borderline: approximately 3 mm) before surgery using MRI. None of the 10 patients treated with radical surgery displayed lymph node metastases. In addition, all 12 study patients exhibited no recurrence (mean: 49 months) and survived.ConclusionsMRI can be used to detect preinvasive and microinvasive disease before surgery. It is possible to select a less invasive surgical method than radical surgery in cases of preinvasive and microinvasive PSCC in view of the indolent clinical behavior of this disease.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2407-14-784) contains supplementary material, which is available to authorized users.
Highlights
Papillary squamous cell carcinoma (PSCC) of the uterine cervix is difficult to diagnose due to its rarity and limited data regarding its clinical behavior
We found 28 surgical patients who were initially diagnosed with PSCC of the uterine cervix on the colposcopic selective biopsy
We divided the 28 patients into true PSCC patients, who were diagnosed with PSCC on both the colposcopic selective biopsy and surgical specimens, and false PSCC patients, who were initially diagnosed with PSCC on the colposcopic selective biopsy, and whose diagnosis changed on the surgical specimens to a condition other than PSCC
Summary
Papillary squamous cell carcinoma (PSCC) of the uterine cervix is difficult to diagnose due to its rarity and limited data regarding its clinical behavior. Lesions with a gross appearance including carcinomatous or papillary growth on the cervix are diagnosed as invasive carcinoma based on the International Federation of Gynecology and Obstetrics (FIGO) staging (NCCN Guidelines, version 2.2013). In such cases, the recommended treatment is radical hysterectomy with lymphadenectomy or radiation therapy (NCCN Guidelines, version 2.2013). The recommended treatment is radical hysterectomy with lymphadenectomy or radiation therapy (NCCN Guidelines, version 2.2013) These lesions may contain elements of preinvasive and microinvasive disease. It is difficult to identify the best treatment strategy for PSCC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
