Prostatic gland ectopia in the uterine cervix: a diagnostic pitfall – case report

Abstract Background The occurrence of ectopic prostatic tissue in the female genital tract is an extremely rare condition, usually discovered incidentally. This anomaly has been reported in various parts of the genital tract, including the uterus, cervix and vagina, and is believed to be related to embryonic remnants or metaplastic alterations of normal tissues. The presence of ectopic prostatic tissue (EPT) in women without hormonal, gonadal or genetic disorders is an uncommon finding. Studies suggest that high levels of androgens may be associated with the development of EPT. Microscopic findings are poorly described, so this paper aims to describe the histopathological and immunohistochemical findings in a rare case of EPT diagnosed in a 39-year-old cisgender woman. Case presentation A 36-year-old cisgender female patient, with no comorbidities and no continuous medication use, sought medical care due to a complaint of a “ball sensation in the vagina.” Clinical examination revealed anterior genital prolapse and stage 3 uterine prolapse. The patient underwent a total laparoscopic hysterectomy and prolapse correction. During surgery, foci of endometriosis were found, and the lesions were excised at the same time. Histopathological examinations revealed a small leiomyoma associated with multifocal adenomyosis in the uterine body, a focus of endometriosis in the rectovaginal septum, ulcerated cervical mucosa with moderate chronic inflammation, Naboth cysts, and intraluminal squamous metaplasia in the cervical mucosa. An extensive complementary immunohistochemical study with nine antibodies was required, which was consistent with ectopia of prostatic glands in the cervix.Two months after the surgical intervention, the patient returned for a follow-up evaluation, showing good recovery and reporting no new complaints. Ovarian function was preserved. Conclusion This case highlights the importance of considering TPE in the differential diagnosis of cervical lesions. It also provides more detailed information on the pathogenesis and broadens the understanding of the histological alteration in question.