Endocervical Cavity Anomaly Mimicking the Uterine Cavity and Delaying Diagnosis of Endometrial Adenocarcinoma: A Case Report

Abstract We report a rare case of endometrial cancer in an endocervical anomaly with a dilated and isolated endocervical cavity mimicking the uterine cavity. A 75-year-old woman suffered from persistent brownish watery vaginal discharge. The cytology of the fluid showed some atypical cells, and trans-vaginal ultrasonography disclosed two distinct compartments in the pelvis. Under the impression of hematometra and adnexal cystic tumor with solid part, dilation and curettage (D&C) was done, but the pathology showed no evidence of malignancy. Although the hematometra and adnexal cyst disappeared afterward, the patient returned to the clinic with a complaint of persistent vaginal fluid two months later, and trans-rectal ultrasound revealed a cystic tumor with solid part again. Finally, endometrioid adenocarcinoma of endometrium was diagnosed by diagnostic laparoscopy and hysterectomy. This work highlights our experience in the diagnostic process and calls attention to the possibility of an occult endometrial cancer when evaluating postmenopausal women with continuous abnormal watery vaginal fluid and/or atypical cells shown in vaginal fluid cytology. View Full-Tex