A Case of Cervical Squamous Cell Carcinoma Developing 33 Years After Conization

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Oncology

Background:

• A 73-year-old multiparous woman presented with pyometra and abdominal pain.
• Past medical history included four open surgeries and cervical conization.
• Initial cervical and uterine cavity cytology were negative.

Observation:

• Laparoscopy revealed extensive small bowel adhesions.
• Total hysterectomy was performed, with the uterus retrieved transvaginally.
• Histopathology confirmed invasive squamous cell carcinoma of the uterine cervix, p16 positive.

Findings:

• Three months post-surgery, the patient developed small bowel obstruction.
• Laparotomy identified widespread peritoneal and mesenteric dissemination.
• Biopsy confirmed metastatic squamous cell carcinoma.

Implications:

• This case underscores the potential for occult cervical squamous cell carcinoma (CSCC) to present atypically.
• Early postoperative peritoneal dissemination can occur even after negative initial diagnostics.
• Aggressive tumor biology and potential iatrogenic spread warrant careful consideration in similar cases.