Superficially invasive cervical squamous cell carcinoma metastatic to ovarian endometriotic cyst wall, a case report and brief review of the literature

Minfen Zhang,Qingping Jiang,Hanzhen Xiong,Kyle Molberg,Elena Lucas,Wenxin Zheng,Shaoyan Liu

doi:10.1186/s13048-018-0417-9

Abstract

BackgroundAlthough cases of cervical squamous cell carcinoma metastatic to the ovary have been previously documented, we report the first case of superficially invasive squamous cell carcinoma metastatic to the ovary.Case presentationA 45-year-old woman with a two-year history of ovarian endometriosis confirmed by ultrasound underwent oophorectomy. On microscopic examination, a focus of malignant stratified epithelium, initially interpreted as transitional cell carcinoma, was identified within the endometriotic cyst wall. Examination of the hysterectomy specimen revealed superficially invasive squamous carcinoma of the cervix. In addition, two triploid, CD45-negative cells were detected during the analysis of the peripheral blood for circulating tumor cells (CTC). High-risk HPV was detected on the sections of endometriosis containing cancerous area by using hybrid capture 2 assay, supporting the diagnosis of metastatic squamous cell carcinoma originating from the uterine cervix.ConclusionThis is the first report of superficially invasive squamous cell carcinoma metastatic to the ovary. Such finding could be misdiagnosed as primary ovarian transitional cell carcinoma, squamous cell carcinoma originating from metaplastic epithelium within endometriosis, or squamous cell carcinoma arising in a teratoma.

Highlights

Cases of cervical squamous cell carcinoma metastatic to the ovary have been previously documented, we report the first case of superficially invasive squamous cell carcinoma metastatic to the ovary.Case presentation: A 45-year-old woman with a two-year history of ovarian endometriosis confirmed by ultrasound underwent oophorectomy
This is the first report of superficially invasive squamous cell carcinoma metastatic to the ovary
Such finding could be misdiagnosed as primary ovarian transitional cell carcinoma, squamous cell carcinoma originating from metaplastic epithelium within endometriosis, or squamous cell carcinoma arising in a teratoma

Summary

Conclusion

This is the first report of microinvasive cervical squamous cell carcinoma with a metastasis involving exclusively an ovarian endometriotic cyst wall. A definitive diagnosis was successfully established by careful examination of the entire uterine cervix and comparing the HPV status of the primary and metastatic tumors. This case highlights the morphological similarity between SCCA and other types of primary ovarian cancer. Ethics approval and consent to participate All experiments were performed in strict accordance with the Ethics Committee at Third affiliated Hospital of Guangzhou Medical University. The Institutional Committee of Third affiliated Hospital of Guangzhou Medical University approved the use of all samples. Author details 1Department of Pathology, Third Affiliated Hospital, Guangzhou Medical University, Guangzhou 510150, People’s Republic of China. Author details 1Department of Pathology, Third Affiliated Hospital, Guangzhou Medical University, Guangzhou 510150, People’s Republic of China. 2Key Laboratory of Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou 510150, China. 3Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. 4Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA

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