Archives of Gynecology and Obstetrics

, Volume 269, Issue 3, pp 221–223

Postmenopausal bleeding: squamous cell carcinoma of cervix with coexisting endometrial tuberculosis

  • Shalini Rajaram
  • Geeta Dev
  • Nirupma Panikar
  • Kishor Chandra Singh
  • Neerja Goel
Case Report


Case report

A case of squamous cell carcinoma of cervix co-existent with endometrial tuberculosis presenting as postmenopausal bleeding is being reported for its rarity. The atrophic postmenopausal endometrium is thought to be poorly supportive of tubercle bacilli. Following a radical Wertheim’s hysterectomy patient had a hectic postoperative period, which responded to antitubercular treatment. Diagnosis of tuberculosis in this case was made on histopathology postoperatively and confirmed by polymerase chain reaction (PCR) on scrapes from the granulomas obtained by microdissection.


Tuberculosis complicating malignant disease may occur in regions with a high prevalence of disease; with a resurgence of tuberculosis worldwide this association may not be uncommon. The diagnosis and treatment of tuberculosis in a patient with cancer assumes importance as a high mortality has been seen in patients with co-existent disease.


Squamous cell carcinoma cervix Endometrial tuberculosis Postmenopausal bleeding Polymerase chain reaction for Mycobacterium tuberculosis 


  1. 1.
    Bazaz-Malik G, Maheshwari B, Lal N (1983) Tuberculous endometritis: a clinicopathologic study of 1000 cases. Br J Obstet Gynecol 90:84–86Google Scholar
  2. 2.
    Bulska M, Marianowski L, Wasilewska B (1970) Uterine cervix cancer coexisting with endometrial tuberculosis. Ginekol Pol 41:1135–1138PubMedGoogle Scholar
  3. 3.
    Carneiro PC, Graudenz MS, Zerbini MC, de Menezes Y, dos Santos LR, Ferraz AR (1989) Granulomatous reaction associated with metastatic epidermoid cancer. The importance of using multiple methods in diagnostic pathology. Rev Hosp Clin Fac Med Sao Paulo 44:29–32PubMedGoogle Scholar
  4. 4.
    Chen YM, Chao JY, Tsai CM, Lee PY, Perng RP (1996) Shortened survival of lung cancer patients initially presenting with pulmonary tuberculosis. Jpn J Clin Oncol 26:322–327PubMedGoogle Scholar
  5. 5.
    Collins KR, Quinones Mateu ME, Toossi Z, Arts EJ (2002) Impact of tuberculosis on HIV-1 replication, diversity and disease progression. AIDS Rev 4:165–176PubMedGoogle Scholar
  6. 6.
    Gredmark T, Kvint S, Havel G, Mattison LA (1995) Histopathological findings in women with postmenopausal bleeding. Br J Obstet Gynaecol 102:133–136PubMedGoogle Scholar
  7. 7.
    Hsu C, Yang LC, Hsu ML, Chen WH, Lin YN (1985) The coexistence of carcinoma and tuberculosis in the uterine cervix: report of 2 cases. Asia Oceania J Obstet Gynaecol 11:363–369PubMedGoogle Scholar
  8. 8.
    Inaki J, Rodriguez V, Bodey GP (1974) Causes of death in cancer patients. Cancer 33:568–573Google Scholar
  9. 9.
    Karnak D, Kayacan O, Beder S (2002) Reactivation of pulmonary tuberculosis in malignancy. Tumori 88:251–254PubMedGoogle Scholar
  10. 10.
    Khurana KK, Stanley MW, Powers CN, Pitman MB (1998) Aspiration cytology of malignant neoplasms associated with granulomas and granuloma like features. Cancer 84:84–90CrossRefPubMedGoogle Scholar
  11. 11.
    Kumar RR, Shafiulla M, Sridhar H (1999) Association of tuberculosis with malignancy at KIMIO—an oncology center. Indian J Pathol Microbiol 42:339–343PubMedGoogle Scholar
  12. 12.
    La Grange JJ (1981) Postmenopausal endometrial tuberculosis: a report of 2 cases and literature survey. S Afr Med J 59:501–502PubMedGoogle Scholar
  13. 13.
    Luchian N, Dobreanu N, Cordon Tarabuta G, Costachescu G (1967) Considerations on 2 cases of association between cancer and tuberculosis of the uterine cervix. Rev Med Chir Soc Med Nat Iasi 71:1025–1028PubMedGoogle Scholar
  14. 14.
    MacDougall DS (1999) TB and HIV: the deadly intersection. J Int Assoc Physicians AIDS Care 5:20–27PubMedGoogle Scholar
  15. 15.
    Moodley M, Moodley J, Kleinschmidt I (2001) Invasive cervical cancer and human immunodeficiency virus (HIV) infection: a South African perspective. Int J Gynecol Cancer 11:194–197CrossRefPubMedGoogle Scholar
  16. 16.
    Muechler E, Minkowitz S (1971) Postmenopausal endometrial tuberculosis. Obstet Gynecol 38:768–770PubMedGoogle Scholar
  17. 17.
    O’Connell MJ, Schimpff SC, Kirschner RH, Abt AB, Wiernik PH (1975) Epithelioid granulomas in Hodgkin’s disease. JAMA 233:886–889PubMedGoogle Scholar
  18. 18.
    Samal S, Gupta U, Agarwal P (2000) Menstrual disorders in genital tuberculosis. J Indian Med Assoc 98:126–127PubMedGoogle Scholar
  19. 19.
    Saygili U, Guclu S, Altunyurt S, Koyuncuoglu M, Onvural A (2002) Primary endometrioid adenocarcinoma with coexisting endometrial tuberculosis. A case report. J Reprod Med 47:322–324PubMedGoogle Scholar
  20. 20.
    Toub DB, Goff BA, Muntz HG (1991) Tuberculous endometritis presenting as postmenopausal bleeding. A case report. J Reprod Med 36:616–618PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Shalini Rajaram
    • 1
  • Geeta Dev
    • 2
  • Nirupma Panikar
    • 2
  • Kishor Chandra Singh
    • 1
  • Neerja Goel
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity College of Medical Sciences and Guru Teg Bahadur HospitalShahdara, DelhiIndia
  2. 2.Department of PathologyUniversity College of Medical Sciences and Guru Teg Bahadur HospitalShahdara, DelhiIndia

Personalised recommendations