Answer: Metastatic urothelial carcinoma with Pagetoid spread

Histology: There is marked thickening of the cervical squamous epithelium by atypical cells with no orientation. Where this proliferation interfaces with normal squamous epithelium, the atypical cells undermine and percolate through the cervical epithelium. Mitotic figures are evident.

Discussion: Urothelial carcinoma is characterized by multiple recurrences during its course. Involvement of the gynecologic tract is uncommon, and has only been rarely reported. Nonetheless, when the clinical history of known, spread to gynecologic organs must be suspected. In this case, the history of urothelial carcinoma was known, and the patient had undergone a cystectomy in the past.

Reference(s):
– Am J Surg Pathol. 2012 Jul;36(7):1058-65.