Post-coital bleeding: a rare and unusual presentation of cervical endometriosis

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This case report details a patient whose post-coital bleeding, initially attributed to benign factors, was resolved after a haemorrhagic cervical nodule was diagnosed and treated as endometriosis.

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This paper reports a case of post-coital bleeding in a patient referred to a colposcopy clinic and whose cervical smear showed groups of benign glandular cells of endometrial origin. Although colposcopy appeared normal, excision of a haemorrhagic nodule and subsequent histology demonstrated cervical endometriosis, with resolution of symptoms. The authors’ main caveat is that benign-appearing findings can obscure the true cause, so cervical endometriosis should be included in the differential diagnosis when post-coital bleeding occurs without obvious ectopy or malignancy. This paper is centrally about endometriosis — specifically, it presents a rare case of cervical endometriosis causing post-coital bleeding with confirmatory histology.

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Abstract

INTRODUCTION: Often due to benign conditions such as cervical ectopy, post-coital bleeding is a distressing symptom for the patient. However, for the clinician, the identification of the etiology is important in order to effect proper treatment. CASE REPORT: We present a case referred to the colposcopy clinic because of post-coital bleeding and a smear report of 'groups of benign glandular cells of endometrial origin'. Colposcopy was normal but histology of an excised haemorrhagic nodule revealed endometriosis with resolution of symptoms. CONCLUSION: Cervical endometriosis should be considered in the differential diagnosis of post-coital bleeding with no obvious ectopy or malignancy.
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Abstract

Introduction: Often due to benign conditions such as cervical ectopy, post-coital bleeding is a distressing symptom for the patient. However, for the clinician, the identification of the etiology is important in order to effect proper treatment. Case report: We present a case referred to the colposcopy clinic because of post-coital bleeding and a smear report of ‘groups of benign glandular cells of endometrial origin’. Colposcopy was normal but histology of an excised haemorrhagic nodule revealed endometriosis with resolution of symptoms. Conclusion: Cervical endometriosis should be considered in the differential diagnosis of post-coital bleeding with no obvious ectopy or malignancy.

References

Baker PM, Clement PB, Bell DA, Young RH (1999) Superficial endometriosis of the uterine cervix: a report of 20 cases of a process that may be confused with endocervical glandular dysplasia or adenocarcinoma in situ. Int J Gynecological Pathol 18:198–205 Balachandran I, Gerber M (2002) Presentation of endometriosis of the cervix in cervical smear. A case report and review of literature. J Lower Genital Tract Dis 6:162–166 Doshi J, Doshi S, Sanusi F, Padwick M (2004) Persistent post-coital bleeding due to cervical endometriosis. J Obstet Gynaecol 24:468–469 Fukunaga M (2001) Uterus-like mass in the uterine cervix: superficial cervical endometriosis with florid smooth muscle metaplasia? Virchows Arch 438(3):302–305 Hanau CA, Begley N, Bibbo M (1997) Cervical endometriosis: a potential pitfall in the evaluation of glandular cells in cervical smears. Diagnostic Cytopathol 16:274–280 Kano H, Kanda H (2003) Cervical endometriosis presented as a polypoid mass of portio cervix uteri. J Obstetr gynaecol 23:84–85 Lundeen SJ, Horwitz CA, Larson CJ, Stanley MW (2002) Abnormal cervicovaginal smear due to endometriosis: a continuing problem. Diagnostic Cytopathol 26:35–40 Szyfelbein WM, Baker PM, Bell DA (2004) Superficial endometriosis of the cervix: a source of abnormal glandular cells on cervicovaginal smears. Diagnostic Cytopathol 30:88–91 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Selo-Ojeme, D., Freeman-Wang, T. & Khan, N.H. Post-coital bleeding: a rare and unusual presentation of cervical endometriosis. Arch Gynecol Obstet 273, 370–373 (2006). https://doi.org/10.1007/s00404-005-0034-x Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-005-0034-x

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Condition tags

endometriosis

MeSH descriptors

Coitus Endometriosis Uterine Cervical Diseases Uterine Hemorrhage Endometriosis Endometriosis Endometriosis Female Humans Middle Aged Uterine Cervical Diseases Uterine Cervical Diseases Uterine Cervical Diseases Uterine Hemorrhage

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