Endometrial Tuberculosis: Hysteroscopic Findings of a Clinical Case

Rev Bras Ginecol Obstet. 2019 Jun;41(6):409-411. doi: 10.1055/s-0039-1692634. Epub 2019 Jun 27.

Abstract

Endometrial tuberculosis is a rare diagnosis in the postmenopausal period, and it can mimic a carcinoma. The present article describes the case of a 54-year-old female patient with weight loss, abdominal pain, and ascites. An ultrasonography showed endometrial thickening, and a video hysteroscopy revealed a uterine cavity with formations with cotton aspect covering the entire endometrial surface and the tubal ostia. An anatomopathological evaluation diagnosed endometrial tuberculosis. The treatment was with a standardized therapeutic scheme (ethambutol, isoniazid, pyrazinamide and rifampicin), and the patient evolved with clinical improvement and normal uterine cavity at hysteroscopy. Considering the lack of pathognomonic hysteroscopic findings of the disorder, it is important to disclose the images of the case.

A tuberculose endometrial é um diagnóstico raro na pós-menopausa e pode mimetizar um carcinoma. O presente artigo descreve o caso de uma paciente de 54 anos com perda de peso, dor abdominal e ascite. A ultrassonografia mostrou espessamento endometrial, e a histeroscopia por vídeo revelou uma cavidade uterina com formações que apresentavam aspecto de algodão cobrindo toda a superfície endometrial e os óstios tubários. Uma avaliação anatomopatológica diagnosticou tuberculose endometrial. O tratamento foi com esquema terapêutico padronizado (etambutol, isoniazida, pirazinamida e rifampicina), e a paciente evoluiu com melhora clínica e cavidade uterina normal na histeroscopia. Considerando a falta de achados histeroscópicos patognomônicos do distúrbio, é importante divulgar as imagens do caso.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / microbiology
  • Antitubercular Agents / therapeutic use*
  • Ascites / microbiology
  • Endometrium / diagnostic imaging
  • Endometrium / microbiology
  • Endometrium / pathology*
  • Female
  • Humans
  • Hysteroscopy
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification*
  • Treatment Outcome
  • Tuberculosis, Female Genital / diagnosis
  • Tuberculosis, Female Genital / drug therapy
  • Tuberculosis, Female Genital / pathology*
  • Ultrasonography
  • Uterus / abnormalities*
  • Uterus / diagnostic imaging
  • Weight Loss

Substances

  • Antitubercular Agents