Alemán-Meza Lucía, Gómez-Macías Gabriela Sofía, Barboza-Quintana Oralia, Garza-Guajardo Raquel, Loya-Solis Abelardo
Pathology Department, University Hospital "Dr. Jose E. Gonzalez" and the Autonomous University of Nuevo Leon Medical School, Francisco I. Madero and Gonzalitos, 64460 Monterrey, NL, Mexico.
Case Rep Pathol. 2014;2014:415328. doi: 10.1155/2014/415328. Epub 2014 Dec 22.
Cervical carcinoma is the most common malignancy of the female genital tract and represents the second most common malignancy in women worldwide. Histologically 85 to 90% of cervical cancers are squamous cell carcinoma. Osteoclastic giant cell rich squamous cell carcinoma is an unusual histological variant of which only 4 cases have been reported. We present the case of a 49-year-old woman with a 6-month history of irregular vaginal bleeding. Examination revealed a 2.7 cm polypoid mass in the anterior lip of the uterine cervix. The patient underwent hysterectomy with bilateral salpingo-oophorectomy. Microscopically the tumor was composed of infiltrative nests of poorly differentiated nonkeratinizing squamous cell carcinoma. Interspersed in between these tumor cells were numerous osteoclastic giant cells with abundant eosinophilic cytoplasm devoid of nuclear atypia, hyperchromatism, or mitotic activity. Immunohistochemistry was performed; CK and P63 were strongly positive in the squamous component and negative in the osteoclastic giant cells, while CD68 and Vimentin were strongly positive in the giant cell population and negative in the squamous component. The patient received chemo- and radiotherapy for recurrent disease identified 3 months later on a follow-up CT scan; 7 months after the surgical procedure the patient is clinically and radiologically disease-free.
宫颈癌是女性生殖道最常见的恶性肿瘤，也是全球女性中第二常见的恶性肿瘤。从组织学上看，85%至90%的宫颈癌为鳞状细胞癌。富含破骨细胞巨细胞的鳞状细胞癌是一种罕见的组织学变异类型，仅报道过4例。我们报告一例49岁女性，有6个月不规则阴道出血病史。检查发现宫颈前唇有一个2.7厘米的息肉样肿物。患者接受了子宫切除术及双侧输卵管卵巢切除术。显微镜下，肿瘤由浸润性巢状低分化非角化鳞状细胞癌组成。在这些肿瘤细胞之间散布着许多破骨细胞巨细胞，其嗜酸性细胞质丰富，无核异型性、核深染或有丝分裂活性。进行了免疫组织化学检查；CK和P63在鳞状成分中呈强阳性，在破骨细胞巨细胞中呈阴性，而CD68和波形蛋白在巨细胞群体中呈强阳性，在鳞状成分中呈阴性。患者在3个月后的随访CT扫描中发现复发疾病，接受了化疗和放疗；手术7个月后，患者临床和影像学检查均无疾病。
