|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 1 | Page : 60-61
Glassy cell carcinoma of cervix: A rare case report
Padmapriya Balakrishnan1, Vijayan Sharmila2, Thirunavukkarasu Arun Babu3
1 Indira Gandhi Medical College and Research Institute (IGMC&RI), Puducherry, India
2 Department of OBG, AIIMS, Mangalagiri, Andhra Pradesh, India
3 Department of Pediatrics, AIIMS, Mangalagiri, Andhra Pradesh, India
|Date of Submission||02-Aug-2020|
|Date of Acceptance||20-Feb-2021|
|Date of Web Publication||22-Mar-2021|
Department of OBG, AIIMS, Mangalagiri, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Balakrishnan P, Sharmila V, Babu TA. Glassy cell carcinoma of cervix: A rare case report. Apollo Med 2021;18:60-1
Glassy cell carcinoma is a very rare malignancy occurring in cervix accounting in 1% of cervical cancers. It is a poorly differentiated variant of adenosquamous carcinoma of cervix having aggressive behavior. It was first described by Cherry and Glucksmann in 1956. It typically affects younger women compared to other invasive cervical carcinomas, with a peak incidence in the third to fourth decade. The tumor presents as a rapidly growing bulky exophytic mass, or with a barrel-shaped cervix. The clinical course is that of an aggressive tumor with a tendency to metastasize early. We report a case of glassy cell carcinoma of cervix in a reproductive age group woman due to rarity in incidence. A 35-year-old multiparous woman with regular menstrual cycles presented complaints of bleeding per vaginum for 1 week duration. Her vitals were stable, general and systemic examination were normal. Perspeculum examination revealed a nonulcerated mass of 1.5 cm × 1.5 cm arising from posterior lip of cervix. There was no pelvic or parametrial extension of mass. Excisional biopsy was done and the histopathological examination showed cervical epithelial in situ and infiltrative tumor made up of nest and diffuse sheets of tumor cells with prominent cell border, ample eosinophilic to glassy cytoplasm with large ovoid nucleus and prominent nucleoli associated with inflammatory cells such as eosinophils, lymphocytes and plasma cells [Figure 1],[Figure 2],[Figure 3]. Based on the classic tumor histology, the diagnosis of glassy cell carcinoma of cervix was made. Magnetic resonance imaging evaluation did not reveal any evidence of pelvic or parametrial extension, or distant metastasis.
|Figure 1: Microphotograph showing cervical epithelial in situ tumor cells (H and E)|
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|Figure 2: Infiltrative part of tumor showing tumor cells arranged in diffuse sheets with cells having prominent cell border, glassy clear cytoplasm, and large ovoid nucleus having prominent nucleoli (H and E, ×400)|
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|Figure 3: Tumor cells in cervical stroma are associated with eosinophils, lymphocytes (H and E, ×400)|
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The patient was staged as having Federation of Gynaecology and Obstetrics stage IB1 cervical cancer. Treatment options were discussed with the patient after informing the aggressive nature of the tumor, risks of metastasis and recurrence. She opted for a conservative procedure and underwent radical trachelectomy procedure. She is under regular strict follow-up for early detection of recurrence or distant metastasis.
Glassy cell carcinoma of cervix has poor prognosis due to high chance of local recurrence, infiltration into adjacent structures and distant metastasis to lungs, liver, or spleen. The biologic behavior of glassy cell carcinoma is similar to the other poorly differentiated carcinomas, but it distinguishes itself by affecting younger patients, thereby making early recognition extremely important. Patients who present with smaller, exophytic masses tend to be diagnosed earlier, and when treated aggressively, perform better than those patients who present with endophytic tumors. The three histological criteria needed to diagnose the glassy cell carcinoma of cervix are tumor cells with ground glass or finely eosinophilic cytoplasm that stain positive with periodic acid–Schiff stain, prominent cytoplasmic borders, and large round to ovoid nucleus with prominent nucleoli., Treatment is aggressive with radical hysterectomy and adjuvant irradiation. Only few cases of glassy cell carcinoma cervix managed by conservative methods have been reported. Cases of glassy cell carcinoma involving endometrium and colon have also been reported.,
The differential diagnosis of glassy cell carcinoma of cervix has to be considered in all young women with cervical lesion and evaluation has to be done in a rapid manner because of its highly aggressive and metastatic behavior. This article also insists on early diagnosis and treatment of glassy carcinoma for better clinical outcome.
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[Figure 1], [Figure 2], [Figure 3]