Invasive inflammatory pseudotumor of uterine cervix: a case report

Abstract

Background: Inflammatory pseudotumor (IPT) of the cervix uteri has been reported in only one patient. Here, we present a case of cervical IPT with bilateral parametrial involvement causing hydroureteronephrosis.

Case: A 48-year-old, gravida 2, para 1, woman was referred for evaluation of lower abdominal pain and right-sided hydroureteronephrosis. On speculum and colposcopic examinations, the cervix appeared normal. Computed tomography scan revealed a 5 cm x 4 cm mass in the cervix invading both parametria. At laparotomy, the cervix was globally enlarged and both parametria were infiltrated by a tumor of rubbery consistency. After freeing both ureters, the cervix was removed with bilateral parametria and 2-cm vaginal cuff. Histologically, the tumor was characterized by proliferation of fibroblast-like spindle cells and diffuse infiltration of plasma cells and lymphocytes. Immunohistochemical staining showed that the lymphocytes were polyclonal. Immunostaining for smooth muscle actin was negative. The tumor was thus identified as inflammatory pseudotumor. Cervical stroma, bilateral parametria, and subepithelial tissues of the vagina were involved with tumor. However, invasion was not identified in the epithelia of the cervix and vagina or surgical margins of the resected specimen. Postoperative course was uneventful. There is no evidence of recurrent disease 8 months following surgery.

Conclusion: The case we present is the second reported case of cervical IPT. It is unique in showing locally aggressive behavior. Surgical resection appears to be the treatment of choice for IPT.