Transhymenal Vaginoscopic Resection of a Large Polypoid Cervical Endometriosis in an Adolescent Girl: Case Report and Literature Review

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A 13-year-old girl with a large polypoid cervical endometriosis presented with abnormal vaginal bleeding and underwent transhymenal vagino-resectoscopy for resection.

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This paper reports a case of a 13-year-old, presexual adolescent with a large polypoid cervical endometriosis measuring 9 cm, who presented with abnormal vaginal bleeding. Using transhymenal vagino-resectoscopy, the authors performed complete polyp resection in two sessions, with diagnosis confirmed only by histopathology. The report provides a literature review emphasizing that cervical endometriosis has distinct clinical presentations and management depending on whether it is superficial, deep, or polypoid, and it notes that the role of hysteroscopy-vaginoscopy–type approaches remains relatively rare. This paper is centrally about endometriosis — specifically, transhymenal vaginoscopic resection of large polypoid cervical endometriosis in an adolescent.

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Abstract

Cervical endometriosis is an uncommon site and a distinctive entity of this enigmatic disease. It has a different clinical presentation, more difficult diagnosis and dissimilar management approach. Endometriosis of the cervix can be classified into superficial, deep and polypoid.Superficial cervical endometriosis may appear on cervical smears as atypical glandular cells and may present with intermenstrual spotting or postcoital bleeding. It is usually treated by colposcopic loop excision or cryocautery. Patients with deep cervical endometriosis complaint mainly of chronic pelvic pain and treated like traditional deep infiltrating endometriosis of the pelvis. The polypoid form frequently presents with abnormal vaginal bleeding and treated by polypectomy in most of the cases.The case presented in this report was a presexual 13-year-old adolescent girl with a large polypoid cervical endometriosis (9 cm in maximum dimension) who presented with abnormal vaginal bleeding. Complete resection of the polyp was performed in two sessions of transhymenal vagino-resectoscopy. Diagnosis was only confirmed by histopathological examination. This was a rare example of the possible role of hysteroscopy in the management of some forms of endometriosis.
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Abstract

Cervical endometriosis is an uncommon site and a distinctive entity of this enigmatic disease. It has a different clinical presentation, more difficult diagnosis and dissimilar management approach. Endometriosis of the cervix can be classified into superficial, deep and polypoid. Superficial cervical endometriosis may appear on cervical smears as atypical glandular cells and may present with intermenstrual spotting or postcoital bleeding. It is usually treated by colposcopic loop excision or cryocautery. Patients with deep cervical endometriosis complaint mainly of chronic pelvic pain and treated like traditional deep infiltrating endometriosis of the pelvis. The polypoid form frequently presents with abnormal vaginal bleeding and treated by polypectomy in most of the cases. The case presented in this report was a presexual 13-year-old adolescent girl with a large polypoid cervical endometriosis (9 cm in maximum dimension) who presented with abnormal vaginal bleeding. Complete resection of the polyp was performed in two sessions of transhymenal vagino-resectoscopy. Diagnosis was only confirmed by histopathological examination. This was a rare example of the possible role of hysteroscopy in the management of some forms of endometriosis. Similar content being viewed by others Data Availability Data and material used can be accessed when required.

References

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endometriosis

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Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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