A case of adenosquamous carcinoma, so-called glassy cell carcinoma, coexisting with small cell carcinoma of the uterine cervix

<p>Background : We report a case of adenosquamous carcinoma, the so-called “glassy cell carcinoma (GCC)” of the uterine cervix, coexisting with small cell carcinoma.</p><p>Case : A woman in her thirties presented to us complaining of abnormal vaginal bleeding. We performed a direct cervical smear cytology, which revealed atypical cells with small, naked nuclei and fine granular chromatin, as well as atypical cells with large nuclei and distinct nucleoli in a sheet-like arrangement. The suspected cytopathological diagnosis was small cell carcinoma coexisting with adenocarcinoma. A biopsy revealed features of an invasive carcinoma with neuroendocrine differentiation. We diagnosed the patient as having clinical stage IB2 cervical cancer and performed total hysterectomy. Histopathology of the surgically resected specimen revealed GCC with a small cell carcinoma component. No metastases were found in the dissected pelvic lymph nodes, and the pathological disease stage was determined as pT1b1N0M0. The patient was administered postoperative chemotherapy, and no recurrence or metastasis was observed until the last examination conducted six years after the surgery.</p><p>Conclusion : Although GCC is rare, recognizing that this histology can be encountered in clinical practice is important. When the cytological features do not fully satisfy the criteria for adenocarcinoma or squamous cell carcinoma, the possibility of GCC should be considered. Also, coexistence of multiple histological types is frequently observed in cervical small cell carcinoma. A careful examination of cytopathological specimens is crucial, because small cell carcinoma cells can coexist with a non-small cell carcinoma component.</p>