Cervical endometriosis mimicking cervical adenocarcinoma: A case report

Cervical endometriosis is a rare benign condition characterized by ectopic endometrial glands and stroma within the cervix. Its clinical and imaging features resemble those of cervical adenocarcinoma, making preoperative diagnosis difficult. This report concerns the case of a 41-year-old woman who presented with abnormal genital bleeding. Magnetic resonance imaging revealed a multicystic cervical mass with suspected solid components showing high T2 signal intensity and focal high signal on T1-weighted imaging, and positron emission tomography-computed tomography showed moderate uptake of fluorodeoxyglucose. Despite repeated evaluations, including cervical cytology, curettage, needle biopsy, and conization, no malignancy or endometriosis was detected. Owing to the persistent concern of gastric-type cervical adenocarcinoma, robot-assisted hysterectomy was performed. Intraoperatively, the lesion was adherent to the right ureter, prompting a conversion to laparotomy. Frozen sections revealed endometriosis. The final histopathological examination confirmed the presence of cervical endometriosis. This case highlights the diagnostic challenges associated with cervical endometriosis and the risk of overtreatment. When imaging reveals a multicystic cervical lesion, this rare condition should be considered in the differential diagnosis to avoid unnecessary radical surgery.