Stage IIa cervix carcinoma with metastasis to the heart: Report of a case with immunohistochemistry, flow cytometry, and virology findings

Objective. The aim of this study was to report a stage IIa squamous cell ce rvix carcinoma with intraperitoneal carcinomatosis and metastasis to the he art in a 50-year-old woman and to study the original tumor for expression o f oncogenes and tumor suppressor gene proteins, for DNA ploidy, and for hum an papillomavirus (HPV) infection. Methods. Clinical course, histopathology of the original tumor, and autopsy record were rewieved. The original tumor was analyzed for expression of CD 44 variant 6, p16, p21, p53, retinoblastoma (Rb), and c-erb-2. DNA flow cyt ometry was performed on tissue samples from the original tumor and from the heart. Sequences of the HPV genome on cervical and cardiac tissue samples were amplified by polymerase chain reaction. Results. Immunohistochemical analysis showed expression of CD44v6 and p16. No expression of p21, Rb, c-erb-B2, and p53 was seen. DNA flow cytometry of the original cervical tumor showed a DNA index (DI) of 1.0. DNA flow cytom etry of tissue samples from the posterior wall and from the right ventricle of the heart showed two different aneuploid cell populations with DI of 1. 6 and 2.2, respectively. HPV gene sequences were identified neither in the original tumor nor in the heart. Conclusions. To our knowledge, this is the first case of cervix carcinoma w ith metastasis to the heart with immunohistochemistry, flow cytometry, and virology findings. (C) 2000 Academic Press.