HPV in situ hybridization with catalyzed signal amplification and polymerase chain reaction in establishing cerebellar metastasis of a cervical carcinoma

We report an unusual case of cerebellar metastasis from a cervical adenosqu amous carcinoma in which molecular techniques assisted in establishing the correct diagnosis. The patient was a 43-year-old woman with surgically unre sectable cervical carcinoma diagnosed 2 years before presenting with neurol ogical symptoms. A magnetic resonance imaging scan showed a large, enhancin g cerebellar lesion with significant brain stem compression. The excised ce rebellar tumor resembled a small cell carcinoma and was initially not thoug ht to be a metastasis from the cervical adenosquamous carcinoma. In situ hy bridization with catalyzed signal amplification and polymerase chain reacti ons with primers specific for human papilloma virus (HPV) types 16 and 18 w ere used to determine the relationship between the cervical and the cerebel lar neoplasms. A positive signal was present in the nuclei of both neoplasm s by in situ hybridization using HPV16/18 DNA probes. Polymerase chain reac tion revealed the presence of HPV-18 DNA sequences in the cervical and cere bellar neoplasms confirming that the cerebellar neoplasm was a metastasis f rom the cervical primary. HUM PATHOL 30:587-591. Copyright (C) 1999 by W.B. Saunders Company.