Endometrial adenocarcinoma presenting as a hematotrachelos.

Abstract

Hematotrachelos, distension of the uterine cervix with accumulated blood, is an extremely rare condition resulting from a congenital anomaly or an acquired condition. We present a case in which an acquired hematotrachelos was the presenting sign of endometrial cancer. An asymptomatic 66-year-old woman was found to have a bulging cervix during a well-woman visit. Further workup revealed a hematotrachelos and an underlying endometrial adenocarcinoma. She was treated with surgery and adjuvant radiotherapy. A hematotrachelos, although rare, can prevent vaginal bleeding, which is often the earliest symptom of a uterine malignancy. This case report illustrates the potential importance of the pelvic examination as part of the well-woman physical examination, because it led to the discovery of early-stage endometrial cancer.