Case Report Papillary Serous Carcinoma of the Uterine Cervix with Lung Metastasis Maliha Khan, 1 Alan D. Gilman, 1 Sobia Nizami, 2 Aram Barbaryan, 1 Alaa M. Ali, 1 and Aibek E. Mirrakhimov 1 1 Department of Internal Medicine, Saint Joseph Hospital, 2900 North Lake Shore, Chicago, IL 60657, USA 2 Department of Medicine, Agha Khan University, Karachi, Sindh, Pakistan Correspondence should be addressed to Maliha Khan; doc.maliha@gmail.com Received 2 January 2014; Accepted 22 January 2014; Published 4 March 2014 Academic Editors: K. Jamil and S. Ohno Copyright © 2014 Maliha Khan et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Papillary serous carcinoma of the uterine cervix is a rare histological variant of cervical adenocarcinoma, with a very small number of cases reported. It is an aggressive tumor and is usually diagnosed at advanced stages by the time of diagnosis. Early-stage tumors can be treated with surgery and/or radiotherapy, while late-stage tumors have been treated with chemotherapy plus radical surgery with intermittent success. Here we report a case of metastatic papillary serous carcinoma observed at our hospital, which has been treated with debulking surgery and combination chemotherapy with carboplatin and paclitaxel. 1. Introduction Cervical adenocarcinoma accounts for 10–20% of inva- sive cervical cancers and has a poor radiosensitivity and chemosensitivity [1, 2]. Papillary serous carcinoma of the uterine cervix (PSCC) is a very rare variant of cervical adenocarcinoma, which histologically resembles the same tumor occurring more commonly in the ovary, fallopian tube, endometrium, and peritoneum [3]. It is recognized as an aggressive neoplasm that can be pure or mixed with other adenocarcinoma subtypes [3]. PSCC is staged similarly to other types of cervical cancer and is presented in Table 1 [4]. It is usually found with lymph node metastases and occasionally in Stage III or IV (staging is presented in Table 1)[2]. he diagnosis of PSCC should be made ater metastasis from other sites, particularly the endometrium, has been excluded [5]. here is a paucity of the literature on PSCC with only 46 cases being reported to date [2]. Here we describe a recent case of primary PSCC with pulmonary metastases diagnosed at our hospital. 2. Case Presentation A 64-year-old African American female, gravida (G) 0 with menopause at age 52, presented with a four-week history of vaginal bleeding in July 2013. he bleeding occurred daily, ranging in severity from spotting to moderate bleeding. Her review of systems was otherwise negative, and she had no documented past medical history. She reported that her last Pap smear was performed several years ago and was normal. he vital signs were unremarkable. On pelvic examination, cervical ulceration of 2-3 cm with friability was found. he physical examination was otherwise unremarkable. Laboratory investigations showed only microcytic ane- mia with a hemoglobin level of 11.3 g/dL (normal range: 14.0–18.0 gm/dL) and CA-125 of 343 (normal range: 0– 35 U/mL). On transabdominal ultrasound, a small amount of luid within the endometrial cavity was demonstrated, with no signiicant endometrial thickening. A cervical biopsy was performed, which revealed papillary serous carcinoma with mitotic activity at 4 mitotic igures per 10 high-power ields and occasional psammoma bodies (please see Figure 1). he immunostaining was positive for Ki-67 and p53 and negative for estrogen (ER) and progesterone (PR) receptors. A computed tomography (CT) scan of the abdomen and pelvis showed a luid-illed and distended uterine endometrial cavity with free luid in the posterior cul-de-sac (please see Figure 2). Positron emission tomography (PET) scan revealed extensive lymphadenopathy throughout the abdomen, pelvis, and bilateral hilar lung regions, along with multiple difuse Hindawi Publishing Corporation Case Reports in Oncological Medicine Volume 2014, Article ID 683103, 4 pages http://dx.doi.org/10.1155/2014/683103