Uncommon Location for a Common Disease, Simulating Cervical Cancer: A Rare Case Report


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Abstract

Background:Genital tuberculosis (GTB) is a common form of extra-pulmonary TB with cervical TB being a rare entity accounting for 0.1-0.65% of all TB cases globally. It is usually asymptomatic but may present with infertility, menstrual irregularities, dyspareunia, dysmenorrhoea, or vaginal discharge.

Case Presentation:The present case report briefs about a 39 years old nulliparous infertile woman who presented with complaints of irregular menstrual cycles and amenorrhea with an erosive papillary growth over the cervix simulating invasive cervical carcinoma. Her Pap smear report revealed the presence of granulomas. On cervical punch biopsy also a large number of granulomas were seen and on Ziehl Nielsen staining the diagnosis of TB was further confirmed by the presence of acid-fast rodlike bacilli. The patient responded well to anti-tubercular drugs.

Discussion:GTB in most of the cases remains asymptomatic with infertility being the most common presenting complaint. Other symptoms include menstrual irregularities, amenorrhoea, dysmenorrhoea, dyspareunia, chronic pelvic pain, and occasionally abnormal vaginal discharge. Tuberculous cervicitis is difficult to diagnose clinically and many times mimics cervical malignancy.

Result and Conclusion:Hence, cervical tuberculosis should be kept in the differential diagnosis of cervical cancer especially in an infertile woman from a developing country.

About the authors

Naina Kumar

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences

Author for correspondence.
Email: info@benthamscience.net

Kanikaram Kalyani

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences

Email: info@benthamscience.net

Abhimanyu Sharma

Department of Pathology, All India Institute of Medical Sciences

Email: info@benthamscience.net

Sumitra Sivakoti

Department of Pathology, All India Institute of Medical Sciences

Email: info@benthamscience.net

Mishu Mangla

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences

Email: info@benthamscience.net

References

  1. World health Organization. Tuberculosis Factsheet. 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis#:~:text=Six%20million%20men%2C%203.4%20million,TB%20is%20curable%20and%20preventable
  2. Lee JY. Diagnosis and treatment of extrapulmonary tuberculosis. Tuberc Respir Dis 2015; 78(2): 47-55. doi: 10.4046/trd.2015.78.2.47 PMID: 25861336
  3. Naik SN, Chandanwale A, Kadam D, et al. Detection of genital tuberculosis among women with infertility using best clinical practices in India: An implementation study. Indian J Tuberc 2021; 68(1): 85-91. doi: 10.1016/j.ijtb.2020.08.003 PMID: 33641856
  4. Jindal UN. An algorithmic approach to female genital tuberculosis causing infertility. Int J Tuberc Lung Dis 2006; 10(9): 1045-50. PMID: 16964799
  5. Gupta A, Gupta M, Mankatala U, Khurana N. Primary tuberculosis of cervix mimicking carcinoma: A rare case. J Midlife Health 2014; 5(2): 95-7. doi: 10.4103/0976-7800.133999 PMID: 24970989
  6. Deshmukh S, Deshmukh S. Tuberculosis and hysteroscopy. Bangladesh J Fertil Steril 2022; 2(2): 92-7.
  7. Lamba H, Byrne M, Goldin R, Jenkins C. Tuberculosis of the cervix: Case presentation and a review of the literature. Sex Transm Infect 2002; 78(1): 62-3. doi: 10.1136/sti.78.1.62 PMID: 11872864
  8. Bhardwaj B, Menon A, Singh R. Cervical tuberculosis: A diagnostic dilemma in young mimicking cervical cancer. Int J Reprod Contracept Obstet Gynecol 2022; 11(4): 1306-9. doi: 10.18203/2320-1770.ijrcog20220925
  9. Sharma JB. Current diagnosis and management of female genital tuberculosis. J Obstet Gynaecol India 2015; 65(6): 362-71. doi: 10.1007/s13224-015-0780-z PMID: 26663993
  10. Grace GA, Devaleenal DB, Natrajan M. Genital tuberculosis in females. Indian J Med Res 2017; 145(4): 425-36. doi: 10.4103/ijmr.IJMR_1550_15 PMID: 28862174
  11. Sharma JB, Sharma E, Sharma S, Dharmendra S. Female genital tuberculosis: Revisited. Indian J Med Res 2018; 148: S71-83. doi: 10.4103/ijmr.IJMR_648_18 PMID: 30964083
  12. Tjahyadi D, Ropii B, Tjandraprawira KD, et al. Female genital tuberculosis: Clinical presentation, current diagnosis, and treatment. Infect Dis Obstet Gynecol 2022; 2022: 1-6. doi: 10.1155/2022/3548190 PMID: 36438172
  13. Kesharwani H, Mohammad S, Pathak P. Tuberculosis in the female genital tract. Cureus 2022; 14(9): e28708. doi: 10.7759/cureus.28708 PMID: 36204039
  14. Kumari R, Vaishya V, Khanna G, Chauhan M, Sharma J, Kriplani A. Tuberculosis of the cervix: An uncommon cause of vaginal discharge in a post-menopausal woman. Natl Med J India 2018; 31(3): 149-50. doi: 10.4103/0970-258X.255757 PMID: 31044761
  15. Gupta B, Shree S, Rajaram S, Goel N. Genital tuberculosis: Unusual presentations. Int J Mycobacteriol 2016; 5(3): 357-9. doi: 10.1016/j.ijmyco.2016.06.017 PMID: 27847026
  16. Drancourt M, Carrieri P, Gévaudan MJ, Raoult D. Blood agar and Mycobacterium tuberculosis: The end of a dogma. J Clin Microbiol 2003; 41(4): 1710-1. doi: 10.1128/JCM.41.4.1710-1711.2003 PMID: 12682165

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