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Table of Contents
LETTER TO EDITOR
Year : 2021  |  Volume : 18  |  Issue : 1  |  Page : 60-61

Glassy cell carcinoma of cervix: A rare case report


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 Submission02-Aug-2020
Date of Acceptance20-Feb-2021
Date of Web Publication22-Mar-2021

Correspondence Address:
Vijayan Sharmila
Department of OBG, AIIMS, Mangalagiri, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/am.am_99_20

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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

How to cite this URL:
Balakrishnan P, Sharmila V, Babu TA. Glassy cell carcinoma of cervix: A rare case report. Apollo Med [serial online] 2021 [cited 2021 Apr 11];18:60-1. Available from: https://www.apollomedicine.org/text.asp?2021/18/1/60/311742



Sir,

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.[1] It was first described by Cherry and Glucksmann in 1956.[2] 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.[1],[2] Treatment is aggressive with radical hysterectomy and adjuvant irradiation. Only few cases of glassy cell carcinoma cervix managed by conservative methods have been reported.[3] Cases of glassy cell carcinoma involving endometrium and colon have also been reported.[4],[5]

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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Raina N, Gulati A, Kaushik R, Rana A. Glassy cell carcinoma: A rare variant of cervical carcinoma– Case report with review of literature. Med J DY PatilVidyapeeth 2018;11:565-7.  Back to cited text no. 1
    
2.
Yoon N, Kim JY, Kim HS. Clinical outcomes of advanced-stage glassy cell carcinoma of the uterine cervix: A need for reappraisal. Oncotarget 2016;7:78448-54.  Back to cited text no. 2
    
3.
Ferrandina G, Salutari V, Petrillo M, Carbone A, Scambia G. Conservatively treated glassy cell carcinoma of the cervix. World J Surg Oncol 2008;6:92.  Back to cited text no. 3
    
4.
Callegari C, Algeri P, Buzzi A, Motta T, Manfredini C, Rota SM. A case of endometrial glassy cell carcinoma: A rare entity which necessitates of better understanding. Obstet Gynecol Sci 2019;62:478-82.  Back to cited text no. 4
    
5.
Aru A, Rasmussen LA, Federspiel B, Horn T. Glassy cell carcinoma of the colon with human chorionic gonadotropin-production. A case report with immunohistochemical and ultrastructural analysis. Am J Surg Pathol 1996;20:187-92.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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