An ulcerated mass in the cervix: Carcinoma or tuberculosis

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Date: January-June 2014
From: Tropical Journal of Medical Research(Vol. 17, Issue 1)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Clinical report
Length: 1,373 words
Lexile Measure: 1540L

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Byline: Deepa. Kapoor, Prerna. Kapoor, Niraj. Kumari, Narendra. Krishnani, Pallavi. Aga

Tubercular involvement of the cervix is rare and the clinical presentation often simulates that of cervical carcinoma leading to misdiagnosis. We report here the case of a 31-year-old female who presented with secondary amenorrhea, post-coital vaginal bleeding, lower abdominal pain, and mild low-grade fever. Cervical examination revealed an unhealthy cervix, with an irregular, ulcerated mass that bled on touch, raising the suspicion of a cervical malignancy. Histopathology of the cervical biopsy revealed typical necrotizing granulomas and also confirmed the presence of acid fast bacilli in the specimen. Antitubercular therapy was started and the patient responded, with rapid amelioration of symptoms and regression of the cervical mass. Tuberculosis of the cervix is an uncommonly encountered entity and presentation may closely resemble that of cervical carcinoma. Tuberculosis should be considered an important differential diagnosis of a malignant-appearing lesion of the cervix, especially in areas where it is endemic.

Introduction

Although the incidence of tuberculosis has dramatically declined in the West, it is still common in the developing world. Tubercular involvement of the female genital tract most frequently affects the upper genital tract (endometrium and fallopian tubes), while involvement of the cervix is extremely rare. [sup][1],[2] It is important to highlight such anecdotal cases, as clinical presentation of tuberculosis of the cervix often closely resembles that of cervical carcinoma, leading to misdiagnosis. A high index of suspicion is essential, especially in areas where tuberculosis is endemic, as these cases are potentially curable with medical therapy. As most cases are females in the reproductive age group, timely diagnosis and institution of treatment can help restore a normal and fertile lifespan. We report a case that clinically appeared as a malignant cervical mass, but on the basis of a histopathological report, was diagnosed as cervical tuberculosis.

Case Report

A 31-year-old married female, who presented with secondary amenorrhea and post-coital vaginal bleeding since the last seven to ten years, respectively. She also complained of intermittent, episodic lower abdominal pain and mild low-grade fever off and on. There was...

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Gale Document Number: GALE|A393311267