Metastatic disease in primary squamous cell carcinoma of ichthyosis uteri

Ichthyosis uteri, is an exceedingly uncommon entity, in which the endometrial surface is completely replaced by a multilayered squamous epithelium. Literature reports this condition to be benign, with dysplasia, anaplasia, and possible spread from underlying cervical carcinoma occurring in some cases. Metastasis in such patients is still rarer. We present an elderly multiparous patient with previously diagnosed de-novo transitional-papillary primary endometrial squamous cell carcinoma (SCC) with large areas of ichthyosis uteri and severe dysplasia. Examination showed a firm to hard frontal forehead and scalp swelling. She underwent a radical hysterectomy six years ago for the same. She was advised radiotherapy, which she discontinued. Fine needle aspiration cytology (FNAC) of the forehead swelling revealed a metastatic SCC.