Objective:

To report a rare case of cervical squamous cell carcinoma (CSCC) presenting with obstructive uropathy due to bladder invasion and suspected adrenal metastasis.

Approach:

• Case Presentation: A 74-year-old woman with a history of lung adenocarcinoma presented with urinary symptoms and was diagnosed with HPV-associated CSCC after multiple investigations.
• Diagnostic Procedures: Initial workup included bilateral ureteral stenting and transurethral bladder biopsy, followed by laparoscopic exploration and imaging studies.

Key Findings:

• Bladder invasion by CSCC is rare and can mimic primary urologic disease.
• The patient had a confirmed diagnosis of moderately differentiated CSCC with bladder wall invasion and suspected adrenal metastasis.
• Immunohistochemistry showed a CK7+/CK20−/P63+/p16+ profile, aiding in diagnosis.

Interpretation:

CSCC can present with urinary symptoms due to bladder invasion.

Limitations:

• The adrenal metastasis was not histologically confirmed.
• The initial diagnosis was complicated by the patient's prior lung cancer history.

Conclusion:

CSCC presenting with obstructive uropathy is rare and often misdiagnosed; prompt gynecologic evaluation is crucial.