PAPILLARY SQUAMOUS-CELL CARCINOMA OF THE UTERINE CERVIX - DIAGNOSTIC PITFALLS

A case of papillary squamous cell carcinoma (PSCC) of the uterine cerv ix is reported. The patient was a 73-year-old Japanese woman with acut e renal failure and bilateral hydronephrosis. A cauliflower-like mass was found in the uterine cervix. A uterine cervical biopsy specimen re vealed PSCC in situ, while clinically it was an invasive carcinoma. Ut erine cervical biopsy was performed a second time to confirm its strom al invasion. However, only small fragments were obtained because of he avy bleeding from the tumor and they showed PSCC in situ again. Follow ing this, computed tomography of the pelvis revealed a 5 cm mass in th e uterine cervix, invading the vagina and urinary bladder. Though deep -wedge biopsy, loop electrosurgical excision, or cone biopsy is recomm ended to evaluate PSCC, it may be impossible to perform any of these p rocedures because of bleeding such as that seen in our case. In these circumstances, good communication between pathologists and clinicians is important since lack of communication may cause PSCC to be microsco pically misinterpreted as in situ carcinoma rather than invasive carci noma.