Tuberculous Cervicitis Mimicking Cervical Malignancy: A Diagnostic Challenge
- 1Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
- 2Department of Obstetrics and Gynecology, Occupational Health District Hospital, Bandung, West Java, Indonesia
- 3Department of Pathology, Occupational Health District Hospital, Bandung, West Java, Indonesia
Abstract
Introduction: Tuberculous cervicitis is a rare form of female genital tuberculosis that can closely resemble cervical cancer both clinically and radiologically. Its nonspecific manifestation often leads to diagnostic challenges, delayed recognition, and the risk of unnecessary oncologic management. We report two cases of tuberculous cervicitis presenting with cervical lesions highly suggestive of cervical cancer.
Case Illustration: A 42-year-old multiparous woman presented with vaginal discharge, amenorrhea, fever, and unintentional weight loss. Gynecological examination revealed extensive inflammatory involvement of the ectocervix, raising suspicion of cervical cancer. Cervical cytology was inconclusive. Histopathological examination demonstrated granulomatous inflammation with caseous necrosis and Langhans giant cells, supporting the diagnosis of tuberculous cervicitis in the context of patient’s clinical presentation. Chest radiography showed right pleural effusion; however, microbiological confirmation of pulmonary or pleural tuberculosis was not available. The patient was treated with anti-tuberculosis therapy. A second case involved a 24-year-old nulliparous woman with a six-year history of infertility, secondary amenorrhea, chronic vaginal discharge, and postcoital bleeding. Pelvic examination revealed a friable and irregular cervical lesion. Imaging demonstrated a necrotic cervical mass with associated lymphadenopathy, highly suggestive of advanced cervical cancer. However, cervical biopsy revealed caseating granulomatous inflammation consistent with tuberculosis. The patient also received anti-tuberculosis treatment.
Conclusion: Tuberculous cervicitis should be considered in the differential diagnosis of cervical cancer, particularly in women presenting with abnormal cervical lesions, persistent vaginal discharge, menstrual abnormalities, or infertility. Histopathological examination remains the cornerstone of diagnosis when cytological and radiological findings are inconclusive. Early recognition is essential to prevent misdiagnosis and avoid unnecessary invasive or oncologic treatment, especially in regions with a high burden of tuberculosis.
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BibTeX
@article{zulfa2026tuberculous,
title = {{Tuberculous Cervicitis Mimicking Cervical Malignancy: A Diagnostic Challenge}},
author = {Fadhilah Zulfa and Dian Tjahyadi and Fridya Wulandari Djuwantono and Arifa Rakhmana Abdullah and Achmad Suardi and Oki Meilani Dewi},
journal = {International Journal of Women's Health},
year = {2026},
month = oct,
doi = {10.2147/ijwh.s638056},
url = {https://doi.org/10.2147/ijwh.s638056},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Tuberculous Cervicitis Mimicking Cervical Malignancy: A Diagnostic Challenge
AU - Fadhilah Zulfa
AU - Dian Tjahyadi
AU - Fridya Wulandari Djuwantono
AU - Arifa Rakhmana Abdullah
AU - Achmad Suardi
AU - Oki Meilani Dewi
PY - 2026
DA - 2026/10/26
JO - International Journal of Women's Health
DO - 10.2147/ijwh.s638056
UR - https://doi.org/10.2147/ijwh.s638056
AB - Introduction: Tuberculous cervicitis is a rare form of female genital tuberculosis that can closely resemble cervical cancer both clinically and radiologically. Its nonspecific manifestation often leads to diagnostic challenges, delayed recognition, and the risk of unnecessary oncologic management. We report two cases of tuberculous cervicitis presenting with cervical lesions highly suggestive of cervical cancer. Case Illustration: A 42-year-old multiparous woman presented with vaginal discharge, amenorrhea, fever, and unintentional weight loss. Gynecological examination revealed extensive inflammatory involvement of the ectocervix, raising suspicion of cervical cancer. Cervical cytology was inconclusive. Histopathological examination demonstrated granulomatous inflammation with caseous necrosis and Langhans giant cells, supporting the diagnosis of tuberculous cervicitis in the context of patient’s clinical presentation. Chest radiography showed right pleural effusion; however, microbiological confirmation of pulmonary or pleural tuberculosis was not available. The patient was treated with anti-tuberculosis therapy. A second case involved a 24-year-old nulliparous woman with a six-year history of infertility, secondary amenorrhea, chronic vaginal discharge, and postcoital bleeding. Pelvic examination revealed a friable and irregular cervical lesion. Imaging demonstrated a necrotic cervical mass with associated lymphadenopathy, highly suggestive of advanced cervical cancer. However, cervical biopsy revealed caseating granulomatous inflammation consistent with tuberculosis. The patient also received anti-tuberculosis treatment. Conclusion: Tuberculous cervicitis should be considered in the differential diagnosis of cervical cancer, particularly in women presenting with abnormal cervical lesions, persistent vaginal discharge, menstrual abnormalities, or infertility. Histopathological examination remains the cornerstone of diagnosis when cytological and radiological findings are inconclusive. Early recognition is essential to prevent misdiagnosis and avoid unnecessary invasive or oncologic treatment, especially in regions with a high burden of tuberculosis.
SN - 1179-1411
ER -