Inflammatory pseudotumor of the cervix: Caispe report and review of the literature

The third recorded case of inflammatory pseudotumor of the cervix is reported. Inflammatory pseudotumor is considered to be a benign, self-limited lesion of obscure etiology. The condition is thought to be related to an unusual tissue response to injury, past infection and autoimmune disorders. Although extremely rare at this site, inflammatory pseudotumor should be considered in the differential diagnosis of a mesenchymal lesion or tumor-like inflammatory and reparative-like lesion. In December 2003, an 18-year-old nullipara presented to our hospital for dysfunctional bleeding. A solitary leiomyoma-like growth measuring 4.2x3.8 cm, originating from the cervix, was incidentally found on gynecologic examination. The tumor was surgically excised. Samples were stained by H&E, Gomori, pancytokeratin, vimentin, smooth muscle actin, myoglobin, desmin, S-100, CD-68, Factor VIII and p53. Microscopic evaluation of H&E samples showed a distinctive mesenchymal lesion composed of spindle cells displaying morphological features of myofibroblasts, fibroblasts and histiocytes mixed with a considerable number of inflammatory cells. Immunohistochemical analysis showed positive reaction to vimentin, smooth muscle actin, myoglobin, CD-68, and some tumor cells were unexpectedly positive for S-100. Gomori and Factor VIII emphasized the reticulin/capillary network. Three years after excision of the inflammatory pseudotumor of the cervix with no histologic evidence of malignancy, the patient is feeling well with no signs of relapse. In this as well as in other similar cases we suggest long-term follow up.