544 tic carcinoma or carcinoid tumor, which was not an accurate diagnosis. To obtain an accurate diagnosis, an LEEP cone biop- sy, which yields a larger tissue sample, was performed and resulted in a diagnosis of basaloid carcinoma of the uterine cervix, indicating that diagnostic difficulties can be avoided by obtaining larger specimens for pathologic diagnosis (15). The term “basaloid carcinoma of the uterine cervix” refers to any neoplastic lesion of the uterine cervix analogous to a cutaneous basal cell carcinoma (BCC), and may include some of the recognized morphologic variants of BCC. Among the morphologic characteristics of basaloid carcinomas of the uter- ine cervix are nests or islands of small basaloid cells, hyper- chromatic epithelial cells with high nucleus-to-cytoplasm ratios, and a tendency to palisade at the periphery of the tumor islands. A basaloid carcinoma of the cervix may be associat- ed with squamous dysplasia, in situ SCC, or invasive SCC (16, 17). Immunocytochemistry can occasionally be helpful in iden- tifying the epithelial origin of a basaloid carcinoma of the cervix. Some of these tumors have been shown to be strong- ly positive for high molecular weight cytokeratin (18, 19), whereas others have shown little or no expression of cytok- eratins (17, 20). Most tumors are positive for epithelial mem- brane antigen (EMA), but show little or no expression of vimentin, smooth muscle actin, desmin or neuroendocrine markers (2, 18, 19). The major differential diagnosis of basaloid SCC includes the solid variant of adenoid cystic carcinoma (ACC), small cell carcinoma, and large cell neuroendocrine carcinoma (LC NEC) of the cervix. Solid ACC is distinguished from basa- loid SCC by the focal presence of basement membrane mate- rial enveloped by basaloid neoplastic cells; in addition, the solid variant of ACC may show malignant squamous differ- entiation. Small cell carcinoma may be composed of variably sized nests of relatively small, hyperchromatic tumor cells, which may mimic adenoid basal carcinoma (ABC) and small- er ABC-like nests. Rare cases may present with large neoplas- tic islands having peripheral palisading of tumor cells, which may be confused with the solid variant of ACC (21). Small cell neuroendocrine carcinomas may be diagnosed by immuno- histochemical or ultrastructural demonstration of neuroen- docrine differentiation. Cervical LCNEC, another neoplasm omitted from the current WHO classification of uterine cer- vical neoplasms, is characterized by large cells with vesicu- lar nuclei and prominent nucleoli, a mitotic index in excess of 10 per 10 high-power fields, geographic areas of tumor necrosis, and positive staining with appropriate immunohis- tochemical markers of neuroendocrine differentiation (22, 23). Cervical LCNEC composed of large basaloid islands may mimic basaloid SCC, and may also show a considerable degree of morphologic overlap with solid ACC, a lesion that may contain trabecular structures composed of basaloid cells that palisade at the periphery (22). Accurate diagnosis is of prog- nostic importance because of the biologically aggressive na- Y.S. Kwon, Y.M. Kim, G.W. Choi, et al. ture of this uncommon type of cervical cancer. The lack of standard diagnostic criteria for pure basaloid squamous cell carcinoma of the uterine cervix has made it dif- ficult to predict their precise biologic behavior and to design optimal management strategies. Accumulation of data on these rare tumors is therefore necessary to determine whether their behavior differs significantly from that of conventional cervical SCCs of similar clinical stage. Long-term follow-up of this patient and other such patients is therefore important. REFERENCES 1. Daroca PJ Jr, Dhurandhar HN. 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