The importance of re-examination with deep biopsies in diagnosing cervical malignancies despite multiple negative pathology reports: A case report

Abstract

HighlightsThe role of gynecological examination in diagnosis genital cancer is important as in this case (a woman with stony cervix and frozen pelvis).When we have frozen pelvis and fix stony cervix, taking multiple deep biopsies in spite of previous negative pathologic reports, is necessary.Reviewing the slides by qualified pathologists can help us to achieve true diagnosis when we the physical exam does not match with histopatologic results.Lymphoma should be always in our mind to remind the pathologists.

Failures to Cure and Diagnose Cervical Cancer

“…Errors in the diagnosis of cervical cancer may occur in the Pap smear test and its interpretation so that a large proportion of such tests with normal results are classed as false-negative. Research indicates that 29.3% of women with cervical cancer had received false-negative results a few years ago [15]. The wrong diagnosis by a clinical pathologist could lead to a delayed or inappropriate therapy that may result in legal action from the patient, who suffered from outcomes [15].…”

“…Regarding the above-mentioned cases, to prevent errors in the diagnosis of cervical cancer, Pap smear test is not adequate for proper diagnosis in people with signs of the disease such as bleeding, pain, etc., and also in women at risk for cervical cancer (such as those infected with papillomavirus or those with a family history). Since tumors usually originate from the stromal part of the cervix, their presence cannot be detected by unaffected epithelium and test [15]. Hence, a deep biopsy is essential to providing a definitive and correct report.…”

“…In a case report by Ameri et al, despite several negative cytology test results, malignant cells were detected in a deep biopsy and led to a definitive diagnosis [15]. According to Ameri et al, although final diagnosis is only confirming by histology, reviewing pathology slides before definitive treatment reveals notable discrepancies in diagnoses [15]. Other studies have emphasized the importance and accuracy of colposcopy and sampling compared to Pap smear in detecting the early stages of cervical cancer [15,23].…”

Vaginal Lymphoma: A Possible Cause of Genital Hemorrhage

“…Early and accurate diagnosis significantly influences the prognosis [4,5]. It should be considered in differential diagnosis of patients with vaginal bleeding.…”