A Report of Five Cases

Abstract

We report five transitional cell neoplasms of the uterine cervix: three infiltrating high-grade transitional cell carcinomas and two inverted transitional cell papillomas. The patients with TCCs were aged 34, 73, and 81 years, two presented with vaginal bleeding and the third with a large cystic ovarian mass. The three transitional cell carcinomas had a superficial noninvasive papillary component. Two tumors metastasized, one to the pelvic lymph nodes, the other to the ovary. The two patients with metastasis are alive after radical hysterectomy or total abdominal hysterectomy and chemotherapy, but follow-up is short. The third patient is currently receiving radiotherapy. Microscopically, the transitional cell carcinomas were similar to those originating in the urinary bladder or ovary. The inverted transitional cell papillomas were discovered in the cervixes of young adult women, one of whom had atypical squamous cells on a cervical smear at her presentation. The second patient had a slightly raised lesion in the cervix noted when routine smears were obtained. The microscopic features of the inverted transitional cell papillomas were similar to those of the corresponding tumor of the urinary bladder. It is important to separate transitional cell carcinomas from other papillary cancers of the cervix to delineate their clinical and pathological features and establish the prognostic differences, if any, from squamous cell carcinoma. Inverted transitional cell papilloma of the cervix represents a hitherto undescribed benign neoplasm arising at this site. These cases illustrate that cervical epithelium, which is known to undergo benign transitional cell metaplasia, may also give rise to benign and malignant transitional cell neoplasms.