Objective
The purpose of this study was to analyze the clinicopathologic characters and explore the possible cause of cervical endometriosis.
Study Design
By retrospective review, among 13,566 cases of endometriosis that had been treated in our hospital, 33 cases of pathologically proven cervical endometriosis were extracted.
Results
Of 33 cases, 17 women had abnormal vaginal bleeding or visible cervical lesions; the other 16 women had no obvious clinical manifestations but were diagnosed retrospectively on histopathologic reports. Vaginal delivery or curettage procedures had occurred in 84.8% of patients. Only 2 patients had undergone cervical surgery of cryotherapy or electric excision. Seven cases were misdiagnosed before final surgery with the primary suspicion of cervical myoma, inflammatory cyst, cervical polyp, uterine submucous myoma, melanoma or melanin mole, and cervical cancer. Surgical treatment was performed for all symptomatic patients. No recurrence was seen.
Conclusion
Cervical endometriosis should be distinguished from other benign or malignant cervical lesions. Surgical excision is suggested for symptomatic patients.
Endometriosis is one of the most common benign gynecologic disorders and occurs in approximately 15% of women at reproductive age. Cervical endometriosis is a rarely seen type of endometriosis and usually is found retrospectively on histopathologic reports. Although the most cases are asymptomatic, the condition could also be abnormal vaginal bleeding or variable appearance of cervix. Therefore, the diagnosis before surgery or histologic examination is difficult. To the best of our knowledge, most literature describes cervical endometriosis as sporadic case reports. Here, we report the case series of cervical endometriosis was treated and obtained histologic identification in Peking Union Medical College Hospital, China.
Materials and Methods
During the past 27 years (January 1983-April 2010), 13,566 patients with endometriosis have undergone surgical treatment in Peking Union Medical College Hospital. The diagnosis of endometriosis for these cases was all identified by microscopic pathologic examination. With a review of the medical records and archived pathologic sections, 33 cases of pathologically proven cervical endometriosis were extracted; these cases were identified by data regarding the endometrial glands and the surrounding endometrial stromal cells beneath normal cervical squamous epithelium ( Figures 1 and 2 ) . The clinical features of this case series are described and summarized in the Table . We specifically introduced 4 cases in detail to present their rarely seen or particular clinical manifestations or severe complications.
| Clinical characteristic | Patient, n |
|---|---|
| Total | 33 |
| Symptoms | |
| Main symptoms | 5 |
| Irregular intermenstrual bleeding | 3 |
| Postcoital spotting | 1 |
| Massive vaginal hemorrhage | 1 |
| Asymptomatic | 28 |
| Speculum examination findings | |
| Positive | 17 |
| Bluish, bluish-black, or red nodule 0.2-1.5cm in diameter | 12 |
| Polypoid lesion 3 cm in diameter | 1 |
| Cystic red mass 3-6 cm in diameter | 2 |
| Myoma-like mass 4 cm in diameter | 1 |
| Pelvic mass 5 cm in diameter on residual cervix | 1 |
| None | 16 |
| Parity history | |
| Full-term parturition | 23 (25 times) |
| Vaginal delivery | 17 (18 times) |
| Cesarean section delivery | 7 |
| None | 6 |
| Abortion history | |
| Curettage | 22 (32 times) |
| None | 10 |
| History of cervical surgery | |
| Yes (cryotherapy/electric excision) | 2 (1/1) |
| No | 31 |
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