J Korean Med Sci 2009; 24: 542-5 ISSN 1011-8934 DOI: 10.3346/jkms.2009.24.3.542 Copyright The Korean Academy of Medical Sciences Pure Basaloid Squamous Cell Carcinoma of the Uterine Cervix: A Case Report Basaloid squamous cell carcinoma of the uterine cervix is an extremely rare malig- nancy of the female genital tract with a poorer clinical outcome than squamous cell carcinoma of the uterine cervix. We report a case of pure basaloid squamous cell carcinoma of the uterine cervix. A 70-yr-old woman with vaginal bleeding was referred to our institute. A basaloid squamous cell carcinoma of the uterine cervix, of Interna- tional Federation of Gynecology and Obstetrics (FIGO) stage Ib1, was diagnosed by a loop electrosurgical excision procedure cone biopsy. A radical hysterectomy was performed, along with bilateral salpingo-oophorectomy, pelvic lymph node dis- section, and para-aortic lymph node sampling. Pathologic findings were consistent with a basaloid squamous cell carcinoma confined to the cervix without an extrac- ervical tumor. No further treatment was administered and there was no clinical evi- dence of recurrence during the 12 months of follow-up. Follow-up for the patient is ongoing. Although basaloid squamous cell carcinoma of the uterine cervix is thought to behave aggressively, accumulation of data on these rare tumors is necessary to determine whether their behavior differs significantly from that of conventional cer- vical squamous cell carcinoma of similar clinical stage. These data would be use- ful for defining the best diagnosis and treatment for these rare tumors. Key Words : Basaloid; Carcinoma, Squamous Cell; Cervix Uteri Yong Soon Kwon1,*, Yong Man Kim1, Ga Won Choi2, Young Tak Kim1, and Joo-Hyun Nam1 Departments of Obstetrics and Gynecology1, and Pathology2, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea *Current address: Department of Obstetrics and Gynecology, College of Medicine, Kwandong University, Cheil General Hospital and Women’s Healthcare Center, Seoul, Korea Received : 5 December 2007 Accepted : 7 July 2008 Address for correspondence Yong-Man Kim, M.D. Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, 388-1 Pungnap-2-dong, Songpa-gu, Seoul 138-736, Korea Tel: +82.2-3010-3640, Fax: +82.2-3010-6944 E-mail: ymkim@amc.seoul.kr INTRODUCTION Basaloid squamous carcinoma of the uterine cervix is a rare tumor type characterized by an ulcerated, infiltrating growth pattern; nests or cords of small basaloid cells; prominent peri- pheral palisading of cells in the tumor cell nests; and the ab- sence of significant stromal reaction (1). These tumors can arise from various anatomic sites, including the hypopharynx, base of the tongue, salivary glands, esophagus, anal canal, pro- state, thymus, vulva, and urinary bladder (2-12), but origin of uterine cervix is rare. Basaloid squamous carcinoma of the uterine cervix is neither recognized nor included as a specific histologic subtype in the current World Health Organiza- tion (WHO) classification of cervical tumors. Since basaloid squamous carcinomas are thought to behave aggressively (13) but the evidence of supprting this behavior is not powerful, accurate diagnosis and accumulated data of this tumor are important for their clinical management and prognosis. CASE REPORT A 70-yr-old woman, gravida 8 para 3, was referred to a ter- tiary medical center from a local hospital for vaginal bleeding 542 of 3 weeks’ duration. She had undergone a punch biopsy at the local hospital, which resulted in a preliminary diagnosis of adenoid cystic carcinoma or carcinoid tumor. Her medical history included diabetes mellitus (DM) for 10 yr which had been controlled by medication; in addition, her mother died of uterine cervical cancer. Physical examination showed uter- ine cervical erosion. The biopsy specimen taken at the local hospital showed pathologic evidence of a high grade malig- nant epithelial tumor, with features unusual for a cervical tumor. She therefore underwent a loop electrosurgical exci- sion procedure (LEEP) cone biopsy, which revealed a basaloid squamous cell carcinoma. A colonoscopy, intravenous pyelo- gram, and cystoscopy showed no evidence of metastatic dis- ease. Magnetic resonance imaging showed a 2 cm sized can- cerous mass confined to the cervix, with no evidence of inva- sion of the vagina or fornix and no evidence of pelvic lym- phadenopathy (Fig. 1). The tumor was classified as clinical stage Ib1. A radical hysterectomy was performed, along with bilateral salpingo-oophorectomy, pelvic lymph node dissec- tion, and paraaortic lymph node sampling. The pathologic diagnosis was basaloid squamous cell carcinoma. The depth of invasion was 5/7 mm full thickness of the cervical wall. There was no evidence of tumor in sections taken from 26 lymph nodes. The resection margin of the vaginal cuff was