Simultaneous squamous cell carcinoma in situ and adenocarcinoma in situ of the uterine cervix in a 36-year-old Japanese woman

Simultaneous occurrence of squamous cell carcinoma in situ (SIS) and adenocarcinoma in situ (AIS) is very rare in Japan. The author reports a rare case of coexistence of SIS and AIS in a young Japanese woman. A 36-year-old Japanese woman complained of abnormal uterine bleeding, and consulted to our hospital. Colposcopic examination revealed irregular lesions in the cervix, and a biopsy showed simultaneous SIS and AIS. Conization was performed. The SIS corresponded to cervical intraepithelial neoplasm3, HGSIL, or carcinoma in situ, and AIS was typical AIS. The SIS showed in situ atypical cells without stratification and polarity. The AIS showed tubular or cribriform apparent AIS of mixed endocervical and intestinal type. There was adequate structural and cytological atypia regarded as malignant in both lesions. Most of the areas of SIS and AIS were separated but the two were occasionally seen to merge when involving the glands. Immunohistochemically, both elements were positive for cytokeratins, p53 protein, CEA, and CA125. The Ki-67 labeling was 82% in the SIS and 78% in the AIS. The author reported a Japanese case of combined SIS and AIS, so far infrequently reported in Japanese woman.