An Extreme Case of Chronic Cervicitis Mimicking Cervical Cancer and Causing Third-Degree Prolapse

Abstract

Background: Cervicitis is an inflammatory response of the cervix to stimuli; this response may may be acute or chronic. Chronic cervicitis results from repeated episodes of acute cervicitis or an incomplete treatment of the latter. Most cases are asymptomatic or present with vaginal discharge, intermenstrual bleeding, dyspareunia or postcoital bleeding. Sometimes, this benign condition may present in unusual forms proving to be a diagnostic problem for clinicians. It is uncommon to find huge cervical growths caused by chronic cervicitis with uterovaginal prolapse. This article reports on a case of chronic cervicitis that presented as a cervical growth resembling cervical cancer and that produced a third-degree uterine prolapse. Case: A 55-year-old postmenopausal female presented with an irreducible genital prolapse with an intermittent, foul-smelling, blood-mixed discharge. She had this condition for 10 years. She had a 5×5–cm, irregular, fungating mass protruding out of her introitus. This mass was a cervical growth with a pinpoint os identified using a uterine sound. Thus, a clinical diagnosis of cervical cancer or genital tuberculosis with a third-degree cervical descent was made. A biopsy of the cervical growth revealed chronic cervicitis with no evidence of dysplasia. The patient's uterus was atrophic with a bulky cervix. A panhysterectomy was performed. Results: histopathology testing reconfirmed that this patient had chronic cervicitis. Her postoperative period was uneventful. Conclusions: Any cervical growth should be biopsied for histologic confirmation of cervical carcinoma, genital tuberculosis, and chronic cervicitis. The latter conditions without prolapse can be managed medically in young women, but surgical management is required for menopausal women with prolapse. (J GYNECOL SURG 30:380)