Incisional and excisional biopsy

Histologically, the specimen was made up of multiple pieces of soft tissue composed of fibrous and granulation tissue with neoplastic epithelial cells (Fig 2) as demonstrated by antibodies to keratin.  The neoplastic epithelial cells were haphazardly arranged and were of variable shapes and sizes including small nests (Fig 3).  The neoplastic epithelial cells showed evidence of cellular and nuclear pleomorphism and prominent nucleoli.  The morphology of the epithelial cells is consistent with squamous cell carcinoma.  Given the history of cervical cancer, her previous biopsy was retrieved and the histology of the primary lesion was similar to the metastatic lesion (Fig 4).  Therefore a diagnosis of metastatic cervical cancer to the posterior mandible was rendered. 

Figure 2. Low power (x100) immunohistochemistry stain with AE1/AE3 keratin antibodies demonstrating small islands and clusters of neoplastic epithelial cells occupying the bulk of the specimen. 

 

Figure 3. Low power (x100) H & E histology demonstrating sheets of malignant epithelial cells arranged in small islands and clusters occupying the bulk of the connective tissue.  Compare the histology of this specimen to that of Fig 4.  The histology is that of moderately differentiated squamous cell carcinoma.

 

Figure 4. Low power (x100) H & E histology of the original biopsy (primary lesion) from the cervix.  Please note the morphology of the primary squamous cell carcinoma similar to that of the metastatic (Fig 3).  The histology is of the cervical primary lesion is also moderately differentiated squamous cell carcinoma.