Abdelhalim Diaa
Department of Obstetrics and Gynecology, El-Galaa Teaching Hospital, Cairo, Egypt.
Reprod Sci. 2025 Jul 17. doi: 10.1007/s43032-025-01934-3.
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.
宫颈子宫内膜异位症是这种疑难疾病中一个不常见的发病部位和独特类型。它有不同的临床表现、更难的诊断以及不同的治疗方法。宫颈子宫内膜异位症可分为浅表型、深部型和息肉样型。浅表型宫颈子宫内膜异位症在宫颈涂片上可能表现为非典型腺细胞，可能出现经间期点滴出血或性交后出血。通常通过阴道镜下环形切除术或冷冻烧灼治疗。深部宫颈子宫内膜异位症患者主要主诉慢性盆腔疼痛，治疗方法与传统的盆腔深部浸润性子宫内膜异位症相同。息肉样型常表现为异常阴道出血，大多数情况下通过息肉切除术治疗。本报告中的病例是一名13岁性发育前的青春期女孩，患有巨大的息肉样宫颈子宫内膜异位症（最大直径9厘米），表现为异常阴道出血。通过两次经处女膜阴道切除术完成了息肉的完全切除。诊断仅通过组织病理学检查得以证实。这是宫腔镜检查在某些形式子宫内膜异位症治疗中可能发挥作用的一个罕见例子。
