China Science

BACKGROUND: Small-cell carcinoma (SCC) of the cervix is an uncommon member ofthe neuroendocrine group of cervical carcinomas that is frequently intermixed with a non-SCCcomponent in the form of an adenocarcinoma (ADC) or squamous carcinoma. CASE: Colposcopy revealed acervical mass in a 41-year-old woman and a Pap smear the presence of some tumor cells from SCC,which was confirmed by subsequent biopsy. The patient received 3 cycles of chemotherapy and thenunderwent major surgery. The cervical samples showed areas of endocervical ADC adjacent to andintermixed with the SCC. Reviewing the Pap smear, a previously missed malignancy was recognized. Onsubsequent molecular investigation to assess clonality by microsatellite analysis, the presence ofHR-HPV DNA18 on real-time polymerase chain reaction, p16(INK4a) fluorescence in situ hybridizationstatus and the corresponding immunohistochemical expression supported the hypothesis that the twocomponents of the tumor shared the same cell origin. CONCLUSION: SCC of the cervix is a rare butdistinct HR-HPV-18-related cervical carcinoma often intermixed with a clonally related non-smallcell component consisting of an ADC or squamous carcinoma. The presence of SCC tumor cells in acervical smear should prompt a search for malignant glandular or squamous tumor cells.

Alphandery,C　Dagrada,G　Frattini,M　Perrone,F　Pilotti,S
Department of Pathology and Experimental Molecular Pathology, IstitutoNazionale per lo Studio e la Cura dei Tumori, Milan, Italy.

stratum corneum chymotryptic enzyme　 Neoplasms　 Cervical Smears Carcinoma