Superficial Endometrial Spread of Squamous Cell Carcinoma of the Cervix (Cake Icing): Two Case Reports and Review of the Literature

Abstract

Background: Although squamous cell carcinoma of the cervix is the most common gynecologic malignancy in India, superficial spreading carcinoma of the endometrium is rare. The uterine corpus can be involved by direct extension from cervical growth, but superficial spread without invasion of the underlying myometrium is uncommon. Case: Two cases of squamous cell carcinoma of the cervix with superficial extension to the endometrium are reported. Clinically, both cases presented with pyometra. The tumor had spread superficially into the entire endometrial cavity up to the fundus, totally replacing the columnar epithelium. Results: Both patients were diagnosed as having stage 1b cervical squamous cell carcinoma and were treated with hysterectomy and bilateral salpingo-oophrectomy. One patient was lost to follow-up and the other has remained disease free for 48 months. Conclusions: As squamous cell carcinoma of the cervix with superficial extension to the endometrium is a rare phenomenon, with fewer than 40 cases reported in literature so far, this article has been written to emphasize the need for keeping this possibility in mind in cases of carcinoma of the cervix. (J GYNCOL SURG 28:375)