Peritoneal keratin granulomas: Cytohistological correlation in a case of endometrial adenocarcinoma with squamous differentiation

Granulomatous peritoneal inflammationcan be due to many aetiological factors, mostly nonneoplastic(i.e. bacterial and fungal infections, parasiticinfestations, sarcoidosis, endometriosis, Crohnsdisease, foreign body reaction due to surgical material,plant material after barium enema examination,vegetable fragments from intestinal perforation, andvernix caseosa derived from amniotic fluid) but rarelysecondary to a neoplastic process.1–3 However, peritonealkeratin granulomas (PKG) have been found tobe associated with endometrial and ⁄ or ovarian adenocarcinomawith squamous differentiation,1–6 cervicalsquamous cell carcinoma (particularly followingradiation therapy),1 endometrial atypical polypoidadenomyoma with squamous morulae3 or brokenovarian dermoid cysts.1–3 We report a case of PKGvery similar to that reported by Chen,1 in a patientwith endometrial adenocarcinoma with squamousdifferentiation, and can find no other reports investigatingthe cytohistological correlation of these raregranulomatous lesions.