PMC4706399_01
Microphotographs showing the results of pathological examination. (A, B) Hematoxylin and eosin staining (A) and immunohistochemical staining (B) of a surgical specimen showing squamous cell carcinoma positive for p16. (C, D) Hematoxylin and eosin staining (C) and immunohistochemical staining (D) of a biopsy specimen of the lumbar spine showing metastatic squamous cell carcinoma positive for p16. (E) Immunohistochemical staining of a cerebrospinal fluid cytology specimen showing p16-positive atypical cells fairly conclusive for metastatic cancer from the uterine cervix.
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Immunohistochemical staining of the tumor was positive for p16, a marker for human papillomavirus (HPV) infection in uterine cervical cancer (Fig. 1A and B) 6. CT showed a spinal mass with increased FDG uptake at L2 and L3. CT-guided needle aspiration biopsy of the lumbar spine revealed squamous cell carcinoma positive for p16, consistent with metastasis of the patient's primary carcinoma of the uterine cervix (Fig. 1C and D). After completion of radiotherapy, the PET-CT images demonstrated the decrease in FDG uptake in the L2 and L3 lesions (Figure S1), and the patient had no residual pain. Cerebrospinal fluid cytology showed p16-positive atypical cells fairly conclusive for metastatic cancer from the uterine cervix (Fig. 1E).
MRI of the brain showing abnormal gadolinium enhancement in the swollen left oculomotor nerve (solid arrow). The right oculomotor nerve is indicated by a dotted arrow.
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After completion of radiotherapy, the PET-CT images demonstrated the decrease in FDG uptake in the Th12 lesion (Figure S2), and the patient had no residual pain. Brain CT was unremarkable; however, magnetic resonance imaging (MRI) showed abnormal gadolinium enhancement in the swollen left oculomotor nerve (Fig. 2), with no midbrain abnormalities or leptomeningeal enhancement.