Pyometra associated with malignant lesions of the cervix and the uterus

Abstract

An interference with the natural drainage of the normal or abnormal uterine fluids may provoke complications frequently undiagnosed and often of serious consequence to the patient. Though the term pyometra designates, for clinical convenience, most of the collections of abnormal intrauterine fluid, it offers no clue as to the etiology. Obstruction of the cervical canal was noted by Hippocrates, who advised dilatation of the canal with bougies.19 Pyometra, as an entity, was probably first described by John Clark of London, in 1812.12 Unfortunately, the use of such descriptive terms as acute metritis, acute endometritis, suppurative endometritis, acute uterine catarrh, and hysteritis makes a critical review of the older literature difficult.Despite this lack of terminological uniformity, however, it is evident that the potential seriousness of pyometra was fully appreciated.2, 3, 12, 15 On the other hand, the more recent literature, except for an occasional4, 6, 11, 16, 19, 25 article, rarely emphasize this condition. Though the seriousness of pyometra as a complication of pre- or postirradiation therapy is often mentioned, few stress its relative frequency. A review of both textbooks and journals of the past decade, dealing with the management of uterine malignancies, suggests that many of the authors follow a stereotyped pattern of presentation, in which the original outline contains no allotted space for the problem of pyometra.It is the intent of this report to consider some of the clinicopathological manifestations of pyometra as a complication of malignant diseases of the uterus.