Introduction:
Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy of the cervix. Until date around eighteen cases of SSCC have been reported in the literature. It is an aggressive tumor with poor prognosis. The tumor usually presents at an advanced stage. Similarly, primary melanomas of the uterine cervix are rare tumors with not more than 60 cases reported in the world literature. It also has a poor prognosis. There is no reported case of sarcomatoid carcinoma with malignant melanoma. Here, we are presenting a rare case of cervical carcinoma with histopathology suggestive of SSCC with foci of malignant melanoma proven by immunohistochemistry study.
Case report:
The present case report is about a 42-year-old, Mrs. SR, P5 L3 D1 A1 , presented with the complaints of intermittent bleeding per vaginum since last 3 years and severe pain in the right lower limb since 1 month. On examination, there was a proliferative growth in the cervix. Her magnetic resonance imaging (MRI) showed cervical mass lesion with right parametrial extension invading the right ureter and bladder wall causing hydroureteronephrosis with contiguous bilateral pelvic nodes. There were multiple lesions in the left femur. Diagnosis of carcinoma of cervix International Federation of Gynecology and Obstetrics stage IIIB with distant metastasis was made. Histopathology report was suggestive of sarcomatoid carcinoma with foci of melanocytic melanoma. She was planned to be treated with palliative radiation.
Discussion:
About 90% of cervical carcinomas are squamous cell carcinoma. Adenocarcinoma constitute about 3-4% of all cervical carcinomas. Other rare pathologies are lymphoma, melanoma, sarcoma and metastatic tumors. Our case is a rare combination of sarcomatoid carcinoma with foci of malignant melanoma of cervix.