Stage IIa cervix carcinoma with metastasis to the heart: report of a case with immunohistochemistry, flow cytometry, and virology findings.
OBJECTIVE
The aim of this study was to report a stage IIa squamous cell cervix carcinoma with intraperitoneal carcinomatosis and metastasis to the heart in a 50-year-old woman and to study the original tumor for expression of oncogenes and tumor suppressor gene proteins, for DNA ploidy, and for human papillomavirus (HPV) infection.


METHODS
Clinical course, histopathology of the original tumor, and autopsy record were rewieved. The original tumor was analyzed for expression of CD44 variant 6, p16, p21, p53, retinoblastoma (Rb), and c-erb-2. DNA flow cytometry was performed on tissue samples from the original tumor and from the heart. Sequences of the HPV genome on cervical and cardiac tissue samples were amplified by polymerase chain reaction.


RESULTS
Immunohistochemical analysis showed expression of CD44v6 and p16. No expression of p21, Rb, c-erb-B2, and p53 was seen. DNA flow cytometry of the original cervical tumor showed a DNA index (DI) of 1.0. DNA flow cytometry of tissue samples from the posterior wall and from the right ventricle of the heart showed two different aneuploid cell populations with DI of 1.6 and 2.2, respectively. HPV gene sequences were identified neither in the original tumor nor in the heart.


CONCLUSIONS
To our knowledge, this is the first case of cervix carcinoma with metastasis to the heart with immunohistochemistry, flow cytometry, and virology findings.
Sergi
C
C
Institut für Pathologie, Universität Heidelberg, Heidelberg, D-69120, Germany.
Magener
A
A
Ehemann
V
V
De Villiers
E M
EM
Sinn
H P
HP
D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000556:secondary*; D005260:Female; D005434:Flow Cytometry; D015972:Gene Expression Regulation, Neoplastic; D006338:Heart Neoplasms / Q000235:genetics / Q000556:secondary*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009857:Oncogenes / Q000235:genetics*; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000276:immunology* / Q000821:virology; D011003:Ploidies; D002583:Uterine Cervical Neoplasms / Q000235:genetics / Q000473:pathology*