Tubercular cervicitis clinically mimicking as carcinoma cervix: Two case reports

Tuberculosis caused by Mycobacterium tuberculosis is a prevalent infectious disease in resource challenged countries such as India. Tuberculosis of the female genital tract accounts for a minority of cases. Tuberculosis can have a varied presentation and can even mimic malignancy on clinical presentation, as illustrated by the following 2 cases. The first case was that of a 58 year old female presenting with a prolapsed uterus and a decubitus ulcer which was posted for surgical repair. However, on surgery, a diagnosis of frozen pelvis was made because of adhesions and suspicion of malignancy was high. In the second case, a 38 year old female presented in the gynaecology outpatient department with complains of menometrorrhagia. Her pelvic examination revealed a friable papillary growth on the cervix. The clinical differentials in this case included neoplastic and viral aetiologies. The histopathological diagnosis in both the cases after taking into consideration the history, clinical findings and other ancillary investigations was given as tubercular cervicitis. Ancillary investigations are necessary to exclude other causes of granulomatous inflammation such as Chlamydia trachomatis, Neisseria gonorrhea, Trichomonas vaginalis and Herpes simplex. Various studies have emphasized that the presence of typical granulomas are sufficient for the diagnosis of tuberculosis if other causes of granulomatous cervicitis are excluded. A high index of suspicion for tuberculosis is justified while dealing with cervical lesions in tuberculosis endemic areas.