Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2013; 34(02): 66-71
DOI: 10.4103/0971-5851.116177
ORIGINAL ARTICLE

Papillary squamotransitional cell carcinoma of the uterine cervix: A histomorphological and immunohistochemical study of nine cases

Mani Anand
Department of Pathology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra
,
Sanjay D. Deshmukh
Department of Pathology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra
,
Harveen K. Gulati
Department of Pathology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra
› Author Affiliations
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Background: Papillary squamotransitional cell carcinoma (PSCC) is a distinctive subcategory of squamous cell carcinoma of the uterine cervix. It has a propensity for local recurrence and late metastasis. Histologically, it can be misinterpreted as transitional cell carcinoma, or other papillary lesions of the cervix including squamous papilloma, verrucous carcinoma or cervical intraepithelial neoplasia grade 3 with papillary configuration. Materials and Methods: Nine cases of PSCC of the uterine cervix were diagnosed on a cervical biopsy specimen on routine hematoxylin and eosin (H and E) stained sections. Their clinic-morphological features were analyzed. The cases were further evaluated immunohistochemically by cytokeratin 7 (CK7), cytokeratin 20 (CK20), p53 and Ki-67. Results: The patients ranged in age from 35 years to 75 years; with abnormal uterine bleeding being the most common clinical presentation. All the cases showed papillary architecture with fibrovascular cores lined by multilayered atypical epithelium. Three cell types were observed: Clear, intermediate and basaloid. Stromal invasion was seen in five cases, whereas in the remaining four cases, the biopsy specimen was too superficial to definitely assess invasion. Immunohistochemically, eight cases were CK7 + /CK20 - and one case was CK7 - /CK20 - . All nine cases showed nuclear accumulation of mutant p53. Moderate and high proliferative activity was observed in two and seven cases, respectively. Five of patients for whom follow-up information was available underwent radical hysterectomy and two of them were disease free 18 months following treatment. Conclusion: PSCC of the uterine cervix are a clinicomorphologically distinct group of cervical lesions that display a morphologic spectrum. They are potentially aggressive malignant tumors that should be distinguished from transitional cell carcinoma and other papillary lesions of the uterine cervix.

Keywords

Cervix - cytokeratin 7/cytokeratin 20 - Ki-67 - p53 - papillary squamotransitional cell carcinoma


Publication History

Article published online:
20 July 2021

© 2013. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Kokka F, Verma M, Singh N, Faruqi A, Yoon J, Reynolds K. Papillary squamotransitional cell carcinoma of the uterine cervix: Report of three cases and review of the literature. Pathology 2006;38:584-6.
  • 2 Austin RM, Norris HJ. Malignant Brenner tumor and transitional cell carcinoma of the ovary: A comparison. Int J Gynecol Pathol 1987;6:29-39.
  • 3 Bass PS, Birch B, Smart C, Theaker JM, Wells M. Low-grade transitional cell carcinoma of the vagina - An unusual cause of vaginal bleeding. Histopathology 1994;24:581-3.
  • 4 Albores-Saavedra J, Young RH. Transitional cell neoplasms (carcinomas and inverted papillomas) of the uterine cervix. A report of five cases. Am J Surg Pathol 1995;19:1138-45.
  • 5 Randall ME, Andersen WA, Mills SE, Kim JA. Papillary squamous cell carcinoma of the uterine cervix: A clinicopathologic study of nine cases. Int J Gynecol Pathol 1986;5:1-10.
  • 6 Al-Nafussi AI, Al-Yusif R. Papillary squamotransitional cell carcinoma of the uterine cervix: An advanced stage disease despite superficial location: Report of two cases and review of the literature. Eur J Gynaecol Oncol 1998;19:455-7.
  • 7 Mirhashemi R, Ganjei-Azar P, Nadji M, Lambrou N, Atamdede F, Averette HE. Papillary squamous cell carcinoma of the uterine cervix: An immunophenotypic appraisal of 12 cases. Gynecol Oncol 2003;90:657-61.
  • 8 Koenig C, Turnicky RP, Kankam CF, Tavassoli FA. Papillary squamotransitional cell carcinoma of the cervix: A report of 32 cases. Am J Surg Pathol 1997;21:915-21.
  • 9 Marsh MR. Papilloma of the cervix. Am J Obstet Gynecol 1952;64:281-91.
  • 10 Kazal HL, Long JP. Squamous cell papillomas of the uterine cervix; A report of 20 cases. Cancer 1958;11:1049-59.
  • 11 Kurman RJ, Norris HJ, Wilkerson E. Atlas of tumor pathology. Tumors of the Cervix, Vagina and Vulva. Washington, DC: Armed Forces Institute of Pathology; 1992. p. 75-6.
  • 12 Rose PG, Stoler MH, Abdul-Karim FW. Papillary squamotransitional cell carcinoma of the vagina. Int J Gynecol Pathol 1998;17:372-5.
  • 13 Lininger RA, Wistuba I, Gazdar A, Koenig C, Tavassoli FA, Albores-Saavedra J. Human papillomavirus type 16 is detected in transitional cell carcinomas and squamotransitional cell carcinomas of the cervix and endometrium. Cancer 1998;83:521-7.
  • 14 Odida M. Papillary squamous cell carcinoma of the cervix in Uganda: A report of 20 cases. Afr Health Sci 2005;5:291-4.
  • 15 Ng WK. Thin-layer cytology findings of papillary adenosquamous carcinoma of the cervix. Report of a case with histologic correlation and molecular analysis. Acta Cytol 2003;47:649-56.
  • 16 Kang GH, Min K, Shim YH, Kim KR. Papillary immature metaplasia of the uterine cervix: A report of 5 cases with an emphasis on the differential diagnosis from reactive squamous metaplasia, high-grade squamous intraepithelial lesion and papillary squamous cell carcinoma. J Korean Med Sci 2001;16:762-8.
  • 17 Moll R, Löwe A, Laufer J, Franke WW. Cytokeratin 20 in human carcinomas. A new histodiagnostic marker detected by monoclonal antibodies. Am J Pathol 1992;140:427-47.
  • 18 Lininger RA, Ashfaq R, Albores-Saavedra J, Tavassoli FA. Transitional cell carcinoma of the endometrium and endometrial carcinoma with transitional cell differentiation. Cancer 1997;79:1933-43.
  • 19 Drew PA, Hong B, Massoll NA, Ripley DL. Characterization of papillary squamotransitional cell carcinoma of the cervix. J Low Genit Tract Dis 2005;9:149-53.
  • 20 Fujimoto T, Sakuragi N, Shimizu M, Watari H, Takeda M, Okamoto K, et al. Papillary squamous cell carcinoma of the uterine cervix: A report of two cases with human papillomavirus 16 DNA. Acta Obstet Gynecol Scand 2002;81:176-8.