title: Verrucous carcinoma of the endometrium: a rare and challenging diagnosis.
abstract: Verrucous carcinoma of the endometrium is an exceedingly rare disease with only a few cases reported in the literature. We describe the case of a 68-year-old postmenopausal patient who presented with vaginal discharge. PAP smears were repeatedly reported negative and an endometrial curettage 2 years prior to the diagnosis only showed fragments of benign squamous epithelium. Because of continuous symptoms a hysterectomy was performed and revealed extensive squamous metaplasia of the endometrium with focal transition to verrucous carcinoma. This case demonstrates that benign appearing squamous epithelium in curettage specimens, especially when abundant, is not necessarily ordinary portio epithelium. In this setting, the clinical presentation becomes paramount for considering a well differentiated squamous carcinoma of the endometrium and avoiding diagnostic delay.
authors.affiliation: Institute of Pathology (R.S, W.S, A.B, S.S, F.O), University Teaching Hospital Feldkirch, Feldkirch Department of Obstetrics and Gynecology (W.N), General Hospital Dornbirn, Dornbirn, Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Stockinger
authors.forename: William
authors.initials: W
authors.lastname: Sterlacci
authors.forename: Walter
authors.initials: W
authors.lastname: Neunteufel
authors.forename: Andreas
authors.initials: A
authors.lastname: Boesl
authors.forename: Stefan
authors.initials: S
authors.lastname: Spreitzer
authors.forename: Felix
authors.initials: F
authors.lastname: Offner
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D018289:Carcinoma, Verrucous / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000473:pathology* / Q000601:surgery; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008679:Metaplasia / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D014626:Vaginal Smears