Squamous cell carcinoma of the endometrium with contiguous superficial spreading to the vagina, uterine cervix, fallopian tube, and ovary

The coexistence of cervical and endometrial surface squamous cell carcinoma (SCC) is extremely rare. A 63-year-old woman was referred to the present hospital because of an abnormal Pap smear indicating SCC. Biopsies from the vagina, ectocervix, and endocervix indicated SCC in situ, and endometrial curettage revealed SCC with stromal invasion. The patient underwent a radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Microscopically, the SCC in situ exhibited extensive spread into the vagina, uterine cervix, endometrium, bilateral fallopian tubes, and left ovary. In addition, extensive stromal invasion into the uterine corpus was identified. Polymerase chain reaction revealed human papilloma virus (HPV) type 16 from biopsies from the uterine cervix, corpus, and vagina. SCC of the endometrium may arise secondarily to HPV infection and may spread, in some cases, superficially into the vagina, cervix, and adnexal organs. Additional studies are required to fully elucidate the precise mechanisms of carcinogenesis and tumor spreading in endometrial SCC.