Vaginal Amebiasis Mimicking Cervical Cancer.

A 46-year-old woman presented with lower abdominal pain, diarrhea and irregular vaginal bleeding persisting for the past 2 months. She had a history of cervical cancer treated with concurrent chemoradiotherapy 6 years previously, which was successful. Magnetic resonance imaging with T2-weighted and diffusion images showed a high intensity area in the cervix, suggestive of recurrent cervical cancer (Picture 1). However, a biopsy specimen of the cervix was compatible for amebiasis on hematoxylin/eosin and periodic acid-Schiff staining (Picture 2). A stool specimen demonstrated an ameba trophozoite, which was later confirmed to be Entamoeba histolytica. Blood tests were negative for HIV, syphilis, and hepatitis B, but positive for hepatitis C. Treatment with metronidazole resulted in a rapid clinical response. Vaginal amebiasis may mimic symptoms and imaging findings of cervical cancer (1,2). Physicians must be aware of this rare disease, and a tissue biopsy is essential to make an accurate diagnosis.

Picture 1.

Picture 2.