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Discussion Case #1  
 
n

The diagnosis offered was HSIL / Squamous cell carcinoma

Follow up:

  • Bx was reported as a poorly differentiated Squamous Ca

  • nPt underwent a Wertheim’s hysterectomy

  • nIn 4 months - pt had bilateral lung metastasis

  • Review confirmed presence of  Sq Ca and ....

 
   
     
   
     
   
     
  Pap smear review  
 
  • HSIL was overtly present
  • In addition: scanty small groups or singly scattered cells
  • Nuclei dark & chromatin even
  • Salt & pepper appearance
  • No cytoplasm
  • Features in favor of Neuroendocrine tumour
  • Small cell carcinoma of the cervix
 		  
 
 
 
     
   
     
 
Small Cell Carcinoma
  • •Often overlooked in histology too for poorly differentiated Sq Ca
  • •Basaloid & poorly differentiated areas also mimic SSC
  • •Confers a poorer prognosis
  • •CT required when diagnosed

     

  
   
     
 
Uncommon site
 
  • nLow index of suspicion
  • nNuclear features of SSC are quite typical but may be overlooked when HSIL/Sq Ca  is overpowering n
  • nIt does matter as Rx has to be more aggressive with CT
  
     
 
n
Diagnosis

Mixed Tumor of the Cervix

(Squamous Cell Carcinoma + Small Cell Carcinoma)