Multifaceted Cervical Endometriosis: A Post-Surgical Diagnosis in a Complex Gynecological Case.

Abstract

BACKGROUND Endometriosis is a condition where uterine lining tissue grows outside the uterine cavity, commonly on the ovaries and pelvic peritoneum, but can also occur in rare locations such as the cervix, lungs or pleura. Cervical endometriosis is typically diagnosed retrospectively through post-surgical pathology as it was in this case. This article presents a case of cervical endometriosis with recurrent vaginal bleeding, reviews recent literature to aid in clinical diagnosis and treatment. CASE REPORT A 42-year-old woman presented with a 5-year history of recurrent vaginal bloody discharge. Clinical evaluations revealed a cyst on the posterior wall of the cervix, suspected to be an endometriotic cyst, along with a uterine diverticulum and an endometrial polyp. The patient underwent surgical excision of the cyst, repair of the uterine diverticulum, and removal of the endometrial polyp. Postoperative pathology confirmed the diagnosis of an endometriotic cyst of the cervix. The patient was subsequently treated with oral Dienogest. An 8-month follow-up showed no complaints of discomfort, with gynecological examinations indicating good recovery and no abnormalities detected on ultrasound. CONCLUSIONS Cervical endometriotic cysts are rare but can lead to serious complications if not properly diagnosed and managed. Clinicians should remain vigilant for abnormal symptoms such as recurrent vaginal bleeding and pelvic pain. Timely and appropriate treatment measures, including surgical intervention and hormonal therapy, should be implemented to reduce the risk of complications and monitor for potential malignant transformation. Regular follow-ups are crucial to ensure early detection of any recurrence or progression.