Microinvasive squamous cell carcinoma of the cervix: immunohistochemically detected prognostic factors in a case with poor clinical outcome

Background. Established prognostic factors for cervical cancer are tumor stage, vascular space invasion, tumor size/volume, depth of invasion, and lymph node status. Although patients with superficially invasive lesions have a very good prognosis, cases are still reported which have a poor clinical outcome. Case. We report a case of a 41-year-old woman with very early stromal invasion (0.6 mm deep and <1 mm wide) who presented with a pelvic recurrence at 3 years and then developed an anterior abdominal wall and disseminated peritoneal recurrence 4 years after extrafascial hysterectomy. Archival tissue of the cone biopsy was stained immunohistochemically for CD44v6, Her2-neu, p53, bcl-2, MMP-1 and VEGF and showed positive staining for CD44v6 and MMP-1. Conclusion. The identification of new prognostic factors may enhance our understanding of the biologic behavior of early invasive cancer of the cervix. Our findings suggest that CD44v6 and MMP-1 may be markers worth further investigation in patients with microinvasive cervical cancer. (C) 2003 Elsevier Science (USA). All rights reserved.