Sarcomatoid squamous cell carcinoma of the cervix: A case series and literature review.

Primary cervical sarcomatoid squamous cell carcinoma (SSCC), a rare biphasic malignancy with 29 documented cases, is characterized by co-existing malignant squamous epithelium and sarcomatoid spindle cells. Immunohistochemical co-expression of epithelial (PCK) and mesenchymal (vimentin) markers remains diagnostic. We analyzed 8 institutional cases (2006-2024) alongside literature reports. Patients (median age 46, range 28-72) predominantly presented with vaginal bleeding (7/8 cases), while one exhibited abdominal pain with discharge. HPV16 was detected in 2 cases. All tumors showed variable immunoreactivity for PCK, vimentin, p16, and ≥ 1 squamous marker (p63/p40/CK5/6). Treatment included chemotherapy (6/8) and radiotherapy (3/8). Follow-up (median 57.4 months, n = 7) revealed aggressive behavior: two stage IIIC patients developed supraclavicular/visceral metastases (alive with disease at 10-31 months), one stage IIIA patient died at 24 months, while others remained disease-free. Combined analysis with 29 published cases confirms SSCC's dual histologic presentation (biphasic/monophasic) and consistent epithelial-mesenchymal marker co-expression. These findings underscore SSCC's clinicopathologic heterogeneity and metastatic potential despite multimodal therapy.