Introduction: Synchronous primary malignancies of the female genital tract are rare, comprising a small subset of gynecologic cancers. The concurrent presence of endometrioid endometrial adenocarcinoma and Squamous Cell Carcinoma (SCC) of the cervix is exceptionally rare. It accounts for less than 1% of reported cases. Case Presentation: A 75-year-old postmenopausal woman presented with intermittent vaginal bleeding. Imaging studies revealed a bulky uterus with an endometrial lesion suspicious for malignancy. An initial cervical biopsy identified high-grade papillary SCC of the ectocervix with diffuse p16 positivity. However, the MRI revealed a large endometrial mass that invaded more than 50% of the myometrium. The patient underwent a staging laparotomy with a radical hysterectomy. Histopathological evaluation confirmed two distinct malignancies: a moderately differentiated endometrioid endometrial adenocarcinoma (FIGO Stage IB) with squamous morules and a small, completely excised cervical SCC. No nodal or peritoneal metastases were identified. Postoperatively, the patient received adjuvant external beam radiotherapy and vaginal brachytherapy. Conclusion: This case underscores the importance of a multidisciplinary approach, including immunohistochemistry and imaging, in diagnosing synchronous gynecological malignancies. Recognizing the coexistence of distinct tumors is essential for accurate staging and tailored treatment planning to improve patient outcomes.
Kumar et al. (Mon,) studied this question.