title: Endometrial adenocarcinoma presenting as a hematotrachelos.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Obstetrics, Gynecology, and Reproductive Sciences and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Sauer
authors.forename: Sudeshna
authors.initials: S
authors.lastname: Chatterjee
authors.forename: Gary M
authors.initials: GM
authors.lastname: Israel
authors.forename: Peter E
authors.initials: PE
authors.lastname: Schwartz
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis*; D000368:Aged; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D002577:Uterine Cervical Diseases / Q000209:etiology*