# Primary Low-Grade Peritoneal Serous Carcinoma in a Woman With Psammoma Bodies on Cervicovaginal Cytology

## TL;DR

A 62-year-old woman with rare psammoma bodies in her cervicovaginal cytology was diagnosed with low-grade peritoneal serous carcinoma after thorough investigations.

## Contribution

This case highlights the importance of ruling out malignancy when psammoma bodies are found in cervicovaginal cytology.

## Key findings

- Psammoma bodies in cervicovaginal cytology were found to be associated with low-grade peritoneal serous carcinoma.
- A complete gynecological examination and laparoscopic surgery were necessary to confirm the diagnosis.
- Adjuvant chemotherapy with carboplatin and paclitaxel was administered following the diagnosis.

## Abstract

Psammoma bodies in cervicovaginal cytology are a rare finding associated with malignant tumours. A 62-year-old woman was referred to our centre for cytology with nuclear atypia and psammomatous bodies suspicious of malignancy. A complete gynaecological examination was performed including colposcopy and ultrasound without significant changes. Hysteroscopy was performed to detect endometrial or endocervical malignancy, endometrial biopsy showed psammoma bodies and atrophic endometrium. Endocervical and cervical biopsies were negative for malignancy. Cervicovaginal cytology and human papillomavirus (HPV) testing were repeated. The result was suggestive of adenocarcinoma and negative for HPV. Laparoscopic hysterectomy with bilateral salpingo-oophorectomy was indicated due to two cervicovaginal cytologies with suspicion of malignancy. Low-grade peritoneal serous carcinoma was diagnosed on the surface of the uterus, ovaries and peritoneum. A second laparoscopy was performed to exclude other pelvic or abdominal lesions, and disease was found in the peritoneum of the pelvis, abdomen and omentum. Adjuvant treatment with six cycles of carboplatin and paclitaxel was indicated. Psammoma bodies in cervicovaginal cytology are a rare clinical situation, and it is mandatory to exclude malignancy.