This presentation will explore the challenges and curiosities of cervical pathology through a series of illustrative case studies drawn from routine practice. Cases will highlight common and uncommon diagnostic dilemmas, unusual presentations alongside rare and unexpected entities encountered in cervical pathology.

Vulval squamous cell carcinoma (VSCC) develops through distinct molecular pathways with important diagnostic and clinical implications. Historically regarded as a dichotomous disease comprising HPV-associated and HPV-independent tumours, recent advances have revealed greater biological complexity and refined our understanding of precursor lesions.

This presentation reviews the contemporary classification of vulval squamous precursor lesions within the WHO Classification of Female Genital Tumours. The molecular mechanisms underlying HPV-associated and HPV-independent carcinogenesis are discussed, including the roles of high-risk HPV infection, TP53 alterations, and emerging alternative pathways. The morphologic spectrum of vulval high-grade squamous intraepithelial lesion (HSIL), differentiated vulval intraepithelial neoplasia (dVIN), and related lesions is explored, with particular emphasis on diagnostic pitfalls and areas of overlap.

The practical application of immunohistochemistry, including p16 and p53, is reviewed alongside its limitations. Through a series of illustrative case examples, attendees will gain a pragmatic approach to integrating morphology, immunophenotype, and clinical context in routine practice. By the end of the session, participants should have a clearer understanding of the pathogenesis of VSCC, the evolving classification of precursor lesions, and a practical diagnostic framework for approaching these challenging but clinically important entities.

This is a case based discussion dealing with issues in day to day practice of reporting endometrial cancers including typing, grading, staging and molecular classification. I will discuss some unusual scenarios with odd morphology and immunoprofiles.