Squamous endometrial neoplasia-are Fluhmann's postulates still relevant?

A review of squamous neoplasia of the endometrium (in situ and/or invasive) with or without coexistent similar disease of the cervix, revealed four anatomical variants in 22 patients. The patterns were: Group (i), endometrial squamous neoplasia only; Group (ii), discontiguous endometrial and cervical squamous neoplasia; Group (iii), possibly discontiguous endometrial and squamous neoplasia; and Group (iv), contiguous endometrial and squamous disease. The details of the histology, management and outcome are discussed, the latter being much poorer for the fourth group. The criteria for diagnosing squamous neoplasia involving the endometrium are re-examined and a recommendation for these criteria is suggested.