Glassy cell variant of human papillomavirus associated poorly differentiated adenosquamous carcinoma with concurrent adenocarcinoma in situ: a rare case report

Abstract

Glassy cell carcinoma (GCC) of the uterine cervix is a rare neoplasm, first described by Gluksman and Cherry in 1956. It is a poorly differentiated adenosquamous carcinoma, comprising about 1-2% of all cervical cancers. It is considered to originate from the subcylindrical reserve cells of the cervix and has been associated with human papillomavirus (HPV). Histologically glassy cell carcinoma is composed of nests of large cells with ground glass nucleoli. Nuclear pleomorphism and tumour giant cells are frequently seen. Mitotic activity is brisk. Infiltration by eosinophils and plasma cells with admixture of lymphocytes is a characteristic feature. we report a case of 44-year female who presented with per vaginal bleeding and white discharge which was diagnosed clinically as cervicitis. On pap smear it was reported as NILM- inflammation probably because of its rich inflammatory stroma. Ultrasonography (USG) abdomen and pelvis done which showed mild bulky cervix with changes of cervicitis. We performed P16 which was diffuse block like positivity along with p63 and CK 7 which confirms the adenosquamous presentation and highlights adenocarcinoma in situ arising from endocervical glands. Cervical GCC was recognized as a rare histological entity associated with poor prognosis since the report from Cherry and Glucksmann. We reported a rare case of GCC of cervix variant of poorly differentiated adenosquamous carcinoma associated with HPV and concurrent adenocarcinoma in situ, confirmed on immunohistochemistry.