Abstract
Cervical squamous cell carcinoma (SCC) is an aggressive gynecological malignancy that commonly metastasizes to the lungs, liver, and bones; renal involvement is extremely rare. We report the case of a 68-year-old woman with a history of high-grade cervical SCC, treated a decade earlier with hysterectomy and bilateral salpingo-oophorectomy, who recently presented with right flank pain and hematuria. Imaging revealed a mass involving the bladder and right distal ureter causing hydronephrosis. She underwent a cystoscopy with right ureteral stenting and transurethral resection of the bladder tumor (TURBT). Intraoperative examination revealed a mass in the right lateral vaginal wall. Histopathological examination of the TURBT specimen revealed invasive high-grade non-papillary SCC infiltrating the bladder wall, with sparing of the urothelial mucosa. Immunohistochemistry confirmed human papillomavirus (HPV)-associated, Grade 3 (poorly differentiated) recurrent cervical SCC. A dimercaptosuccinic acid (DMSA) scan demonstrated a non-functioning right kidney, and due to recurrent infections, she underwent a robotic-assisted right nephrectomy. Pathological examination of the renal specimen confirmed metastatic cervical SCC. This case illustrates a rare metastatic pathway of cervical cancer and underscores the importance of multidisciplinary evaluation in complex clinical presentations.