Background: Malignant mixed Müllerian tumors (MMMTs) are aggressive tumors arising in the female lower genital tract and characterized by the presence of both a malignant epithelial and a mesenchymal component. Here, we report a case of an MMMT of the uterine corpus with an extensive squamous-cell carcinomatous component processed by liquid-based cytology (LBC). Case Report: An 84-year-old woman with a prior history of anal squamous-cell carcinoma, who complained of vaginal bleeding, was discovered to have a mass protruding from the uterine cervix. A Papanicolaou (Pap) test was performed and the LBC (ThinPrep) preparation showed a background of neutrophils and cellular debris. Atypical cells were identified that presented with hyperchromatic nuclei, nuclear membrane irregularities, multinucleation and abundant cytoplasm with focal keratinization. Scattered nucleolated malignant elements were also identified. The cytological diagnosis resulted in ‘suspicious for squamous-cell carcinoma', favoring primary cervical carcinoma rather than extracervical (anal) carcinoma. The histological examination showed that it was an MMMT with an extensive squamous-cell carcinomatous component. Conclusion: This case illustrates the potential diagnostic pitfall of MMMTs with extensive squamous-cell carcinomatous components in LBC Pap smears. Cytopathologists should keep in mind this diagnostic possibility in postmenopausal women who experience vaginal bleeding or spotting.

Keywords:
Papanicolaou smear, Liquid-based cytology, Malignant mixed Müllerian tumor
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.