Metachronous Cancer of Breast and Adenocarcinoma of Cervix: A Rare Case Report

The occurrence of a second primary cancer in a cancer survivor is well documented. It may be synchronous or metachronous. Incidence of metachronous cancer involving cervix is 0.82% to 1.33%. One such metachronous cancer is that of breast and cervix. We present a case of a woman who received tamoxifen for invasive ductal cancer of breast following a modified radical mastectomy and subsequently developed adenocarcinoma of cervix after six month of tamoxifen therapy. The role of tamoxifen in pathogenesis of cervical cancer and that of human papillomavirus infection in pathogenesis of both cancer of cervix and breast cancer has been well recognized. In our patient, the adenocarcinoma of cervix (rare occurrence) which is likely due to six month of tamoxifen therapy is a perplexing question. Women diagnosed and treated for breast cancer need to be followed up for development of other metachronous gynecological cancers.

Spontaneous Perforation of Pyometra

Pyometra is collection of purulent material which occurs when there is interference with its normal drainage. It is an uncommon condition with incidence of 0.1 to 0.5% of all gynecological patients. Spontaneous rupture of uterus is an extremely rare complication of pyometra. A 65-year-old lady presented with pain abdomen and purulent vaginal discharge. Preoperative diagnosis of pyometra was made by magnetic resonance imaging (MRI). Laparotomy followed by peritoneal lavage and repair of perforation was performed. Although spontaneously perforated pyometra is rare, the condition must be borne in mind with regard to elderly women with acute abdominal pain. Preoperative diagnosis of perforated pyometra is absolutely essential. Computed tomography (CT) and MRI are diagnostic tools. In selected cases conservative approach at surgery can be opted.

Primary tuberculosis of cervix: a coincidental finding

Background: 95% of Tuberculosis [TB] of the female genital tract [FGT] is located in tissues other than the cervix. A rare case of primary TB of the cervix which was diagnosed coincidently in a patient of endometrioma was reported in this study

Case Presentation: A 34 year old nullipara, a diagnosed case of endometrioma had a small cervical growth. Pap smear and biopsy was taken and sent for histopathological examination. Her histopathological examination revealed multiple epitheloid cell granuloma and langerhans type giant cell caeseation. Ziehl neelsen staining was positive for acid fast bacilli [AFB]. The patient was started on antituberculosis under directly observed therapy along with oral contraceptive pills. Patient was on regular follow- up and clinically she was doing well

Conclusion: Although cervical tuberculosis is very rare but for an abnormal looking cervix, cervical tuberculosis should be considered in the differential diagnosis in woman of all the age groups especially in areas where tuberculosis is rampant since these cases are potentially curable with medical therapy. Many of these patients are in reproductive age group. In young women, early diagnosis prevents further damage in reproductive tract and can improve their reproductive potential