Cervical Tuberculosis in the Postmenopausal Period: A Case of Mistaken Identity With Carcinoma

Female genital tuberculosis (FGTB) is an uncommon manifestation of extrapulmonary tuberculosis that can closely resemble gynaecological malignancies, often resulting in delayed diagnosis and treatment. While the fallopian tubes are the commonest organs to be affected, isolated cervical involvement is exceedingly rare. We report the case of a 60-year-old multiparous woman from a tuberculosis-endemic region in Sudan who presented with severe lower abdominal, pelvic, and perineal pain, along with odourless vaginal discharge persisting for four months. Her condition had rendered her bedridden. Clinical examination revealed a nodular cervix, initially suggestive of cervical cancer. However, histopathological analysis of cervical and endometrial biopsies confirmed caseating granulomas indicative of tuberculosis. The patient had no prior history of tuberculosis or malignancy and had never undergone cervical cancer screening. Imaging showed a uterocervical mass without signs of spinal or metastatic disease, and pulmonary tuberculosis was ruled out via chest X-ray and sputum analysis. She was treated with a standard six-month anti-tuberculosis regimen, resulting in significant clinical improvement and restored mobility. This case highlights the importance of considering cervical tuberculosis in the differential diagnosis of postmenopausal women presenting with pelvic symptoms in endemic areas. Early histological diagnosis and timely initiation of therapy are crucial for favourable outcomes.