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Squamous cell carcinoma of uterine cervix metastatic to the axillary lymph node
  1. Qurratulain Chundriger1,
  2. Uzma Chishti2 and
  3. Romana Idrees1
  1. 1Pathology and Laboratory Medicine, Aga Khan University, Karachi, Sindh, Pakistan
  2. 2Obstetrics & Gynecology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
  1. Correspondence to Dr Qurratulain Chundriger; qurrat.ulain{at}aku.edu

Abstract

We report a case of an elderly woman, presenting with vesicouterine fistula and enlarged axillary lymph nodes. She had been diagnosed with cervical squamous cell carcinoma (SCC) in April 2015, for which she had received brachytherapy and concurrent chemoradiation therapy. The presence of enlarged axillary lymph nodes raised a suspicion for breast cancer with axillary metastases, but the bilateral mammograms did not show any discrete lesion in both breasts. The biopsy from axillary lymph node showed metastatic SCC, with block positivity for P16, confirming the origin from known cervical primary. Axillary lymph nodes are the least likely to be involved by tumours arising in the pelvis, as the lymphatic drainage of this region goes directly to the systemic circulation via the para-aortic lymph nodes and thoracic ducts. A complete clinical history is essential in such cases, to avoid misdiagnosis. Positron emission tomography CT helps in this regard.

  • cervical cancer
  • gynecological cancer
  • pathology

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Footnotes

  • Contributors QC and RI wrote the manuscript and arranged figures. UC provided clinical details. All authors read the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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