Cervical Tuberculosis in a Young Reproductive age Female Mimicking Cervical Cancer: A Rare Differential Diagnosis

Abstract

 Introduction: Tuberculosis (TB) is a global health challenge, with extrapulmonary cases comprising up to 40%. Genital tract TB significantly impacts reproductive-age women, yet cervical involvement is exceedingly rare, representing only 0.1–0.65% of TB cases. When present, it closely mimics cervical carcinoma both clinically and radiologically, leading to serious diagnostic dilemmas and potential mismanagement, often resulting in unnecessary radical surgical interventions if histopathological confirmation is not pursued.

Aim and Objectives: This case report emphasizes cervical tuberculosis as a rare differential diagnosis in reproductive-age women with malignant-appearing cervical lesions. Its objectives are to describe the clinical and diagnostic features of cervical TB and to highlight the importance of histopathology in distinguishing it from carcinoma, ensuring accurate diagnosis and appropriate management.

Materials and Methods: A young multiparous woman with persistent vaginal discharge and post-coital bleeding underwent pelvic examination, baseline investigations, and cervical biopsy. Histopathological analysis including Ziehl–Neelsen staining was performed. Standard anti-tubercular therapy (ATT) was initiated, and clinical follow-up at six months was undertaken to assess response.

Results: Per speculum examination revealed an irregular friable cervical growth resembling carcinoma. Routine investigations and chest X-ray were normal, and HIV serology was negative. Histopathology showed epithelioid granulomas with caseous necrosis, and Ziehl–Neelsen stain confirmed acid-fast bacilli, establishing cervical TB.After six months ofATT, the lesion completely regressed, confirming an excellent therapeutic outcome.

Conclusion: Cervical tuberculosis, though rare, must be considered in the differential diagnosis of carcinoma-like cervical lesions in young women. Histopathology remains crucial for accurate diagnosis, and timely ATT ensures curative outcomes while preventing unnecessary radical surgery.