Melanoma presenting as atypical glandular cells on cervical cytology

Abstract

Background: While most diagnoses associated with atypical glandular cells (AGCs) are localized to the uterus, a small number of extrauterine malignancies have been reported in connection with this finding. The current case report describes a malignant melanoma of the vulva presenting as an AGC Pap.

Case presentation: A 50-year-old female presented with localized vulvar symptoms. A biopsy was read as non-specific vulvitis. A Papanicolaou test (Pap) done at the time of that biopsy revealed AGCs. At her follow-up visit to evaluate her AGCs, the vulvar lesion was found to have increased in size. A second biopsy documented that the vulvar lesion was malignant melanoma.

Conclusions: All patients with an AGC Pap should undergo colposcopy, endocervical curettage, cervical biopsies (if indicated), and endometrial biopsy in high risk women. Even when the work-up is negative, diligent follow-up is recommended because of the risk of delayed diagnoses and extra-uterine malignancies.

Keywords: atypical glandular cells; cervical dysplasia; abnormal cytology; vulvar cancer; malignant melanoma

Received: December 5, 2011; Accepted: January 14, 2012; Published online: March 29, 2012

Corresponding Author: Peter F. Schnatz, D.O., FACOG, FACP, NCMP, Associate Chairman and Residency Program Director, Department of Obstetrics and Gynecology, The Reading Hospital and Medical Center,P.O. Box 16052; Reading, PA  19612-6052.

E-mail: schnatzp@readinghospital.org