Disseminated endometrial tuberculosis simulating endometrial cancer in an immunocompetent patient: a case report

Abstract

The case of a 58-year-old immunocompetent woman with no relevant medical history, presenting with pelvic pain and postmenopausal bleeding, is reported.  Imaging studies revealed findings compatible with  disseminated endometrial cancer, including pulmonary  lesions suspicious for metastasis, for which advanced gynecological cancer was initially presumed; however,  endometrial biopsy showed necrotizing granulomas with acid-fast bacilli, confirming endometrial  tuberculosis (TB). Likewise, pulmonary TB involvement was evidenced (positive sputum smear), establishing  the final diagnosis of disseminated TBsimulating a gynecological cancer. The patient received standard  anti-TB treatment for six months, with complete  remission of symptoms. A post-treatment follow-up  biopsy was negative for TB. This case emphasizes the importance of considering genital TB in the differential  diagnosis of gynecological neoplasms, even in immunocompetent postmenopausal patients, especially in TB-endemic regions, to ensure timely diagnosis and management.