%0 Journal Article
%T Does "ichthyosis uteri" have malignant potential? : A case report of squamous cell carcinoma of endometrium associated with extensive ichthyosis uteri
%A Kanchan Murhekar
%A Urmila Majhi
%A V Sridevi
%A T Rajkumar
%J Diagnostic Pathology
%D 2008
%I BioMed Central
%R 10.1186/1746-1596-3-4
%X A 65-year-old multi-gravida presented with complaints of abdominal pain and postmenopausal bleeding per vagina for seven months. Her past medical history was insignificant with no history of tuberculosis, inflammatory conditions of the uterus or iatrogenically introduced substances in uterus. She had attained menopause about 15 years back.Gynecological examination revealed atrophic ectocervix flushed with vagina. The vagina appeared normal. Uterus was bulky of around 12 weeks and adnexae were unremarkable. Colposcopy showed schiller's unstained areas on anterior lip of cervix. Ultrasound abdomen showed endometrial thickness of 2.6 cms. and fluid in the endometrial cavity. Ectocervical biopsy showed strips of moderate to severe dysplastic stratified squamous epithelium. Endometrial curetting revealed strips of stratified squamous epithelium showing moderate dysplastic changes. No normal endometrium was seen. The pyometra was drained, following which the patient underwent type-II radical hysterectomy. The procedure was well tolerated and the postoperative period was uneventful.The hysterectomy specimen revealed thickened and widened endometrial cavity with gray white nodule in the sub-adjacent myometrium. The cervix showed no obvious growth. The cut-section of the right fallopian tube showed thickened mucosa. Both the ovaries did not show any gross abnormality.The sections revealed entire endometrium replaced by stratified squamous epithelium showing areas of heavy keratinization, koilocytic changes, nuclear hyperchromasia and moderate increase in nuclear-cytoplasmic ratio indicating low grade dysplastic changes in underlying ichthyosis uteri (Fig 1). Extensive sampling of endometrium revealed few atrophic endometrial glands beneath the dysplastic squamous epithelium (Fig 2). Focal invasive islands of atypical squamous epithelial cells were seen in superficial myometrium (Fig 3). In addition, myometrium showed few foci of adenomyosis. Section from the cervix showed mo
%U http://www.diagnosticpathology.org/content/3/1/4