The role of cervical smear in the diagnosis and management of extrauterine malignancies metastatic to the cervix: three case reports.

This report analyses the clinicopathologic features of three metastatic extragenital neoplasms to the cervix. These examples of metastatic extragenital malignancies to the cervix are cutaneous malignant melanoma, colorectal carcinoma, and breast carcinoma. The diagnosis of these metastatic malignancies was suspected on a historical basis. The value of Pap smears is limited on the other hand, since for a correct diagnosis in all our cases, this examination required corroboration by histological and immunohistochemical analysis. In all these examples of extragenital metastatic neoplasms, as in other cases reported in literature, the patients had undergone cervical smear because of vaginal bleeding, even if Pap smear is considered a questionable maneuver in vaginal bleeding. Accordingly, our article reveals that a great deal of rigorous screening, precise morphological analysis, and plentiful clinical data are mandatory in approaching diagnoses of extracervical malignancies. However, this study did demonstrate that cytology does not alter patient management or outcome. In effect, in accordance with other studies, our cases of metastatic extragenital neoplasms to the uterus have poor prognosis. (c) 2009 Wiley-Liss, Inc.