Hysteroscopic Diagnosis of a Concurrent Placental Site Nodule and Cervical Adenocarcinoma: A Case Report

A 32-year-old woman presented with atypical glandular cells on cervical cytology. Her obstetric history was gravida 2 para 2, with 23 months since her last pregnancy. Colposcopy and biopsy revealed cervical adenocarcinoma. Magnetic resonance imaging and positron emission tomography/computed tomography showed no distant spread but suggested a uterine lesion, which was suspected to be corpus uterine cancer. Hysteroscopy revealed a 15-mm white nodular lesion in the lower uterine body; biopsy suggested a placental site nodule (PSN). Cervical conization confirmed stage IA2 cervical adenocarcinoma. The patient underwent a radical hysterectomy. Final pathology showed no residual carcinoma. The uterine lesion was confirmed as benign PSN via immunohistochemistry. She remained recurrence-free at the two-year follow-up. This is the first reported case of concurrent PSN and cervical adenocarcinoma. Visualization and targeted biopsy allowed accurate diagnosis of PSN, preventing overtreatment. The case highlights the diagnostic value of hysteroscopy and the importance of histological evaluation to differentiate PSN from malignancy.