An interesting finding in the uterine cervix: Schistosoma hematobium calcified eggs.
Schistosoma hematobium infection is an endemic parasitic disease in Africa, which is frequently associated with urinary schistosomiasis. The parasite infection causes epithelial changes and disruption, facilitating the infection by the human papilloma virus and human immunodeficiency virus (HIV). The authors report the case of a 44-year-old African HIV-positive woman who presented an abnormal routine Pap smear. Colposcopy examination revealed dense acetowhite micropapillary epithelium covering the ectocervix, iodine-negative, an erosion area in endocervical canal, and atypical vessels. Histologic examination of the surgical specimens showed numerous calcified schistosome eggs (probably S. hematobium) and a high-grade cervical intraepithelial neoplasia. The relation between S. hematobium infection and bladder cancer is well known; however, this relationship with cervical cancer remains controversial. The symptoms of schistosomiasis of the female genital tract are rather non-specific, and are often misdiagnosed with other pelvic diseases. The familiarity of health professionals with schistosomiasis of the female genital tract is less than expected, even in endemic regions. Therefore, great awareness of this differential diagnosis in routine gynecological practice is of paramount importance.
Gynecology and Obstetrics Department - Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental, Lisbon - Portugal .
Alexia
A
Toller
Gynecology Department - Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo/SP - Brazil .
Ana Carolina
AC
Scopin
Gynecology Department - Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo/SP - Brazil .
Vanessa
V
Apfel
Pathology Department - Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo/SP - Brazil .
Karla Calaça Kabbach
KC
Prigenzi
Gynecology Department - Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo/SP - Brazil .
Fernanda Kesselring
FK
Tso
Pathology Department - Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo/SP - Brazil .
Gustavo Rubino de Azevedo
GR
Focchi
Gynecology Department - Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo/SP - Brazil .
Neila
N
Speck
Gynecology Department - Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo/SP - Brazil .
Julisa
J
Ribalta
Genital Diseases, Female; HIV; Schistosoma hematobium; Schistosomiasis hematobia