Cervical schistosomiasis masquerading as invasive carcinoma: a case report

Cervical schistosomiasis, a rare manifestation in women, can closely resemble invasive carcinoma, posing significant diagnostic challenges. This case highlights the complexities involved in the diagnosis and management of schistosomiasis of the cervix. A 48-years-old premenopausal woman from Ethiopia visited the gynecologic outpatient department for routine cervical cancer screening. Physical examination revealed a 2cmx3cm irregular and fragile cervix. Colposcopy showed type-II transformation zone with significant aceto-white lesions. Initial clinical findings suggested invasive carcinoma, but a punch biopsy revealed a high-grade squamous intraepithelial lesion (HSIL) without basement membrane invasion. Subsequent cold knife conization result showed concomitant cervical schistosomiasis. The patient was treated with praziquantel but did not return for follow-up. This case underscores the importance of considering cervical schistosomiasis in the differential diagnoses for cervical abnormalities, particularly in endemic areas. Given its nonspecific symptoms, which often resemble an invasive carcinoma, a high index of suspicion, thorough history, and physical examination are crucial for diagnosis and treatment of cervical schistosomiasis. As this is a rare manifestation in women, this case adds to the limited literature available on the condition. As this case is likely to be the first of its kind reported in Ethiopia, it underscores the call for greater awareness among health professionals to facilitate appropriate management, and ultimately improve patient outcomes.