Anantapur, Feb 19th: Doctors at KIMS Saveera Hospital, Anantapur, have successfully treated a rare case of cervical cancer in a 42-year-old woman who had a lifelong history of primary amenorrhoea (absence of menstruation) due to a congenital reproductive system anomaly.
Senior Gynaecologist Dr. Geetha Rani Vellidareddy said the patient, a resident of Ballari district in Karnataka, approached the hospital with complaints of white vaginal discharge for the past three months. Notably, she did not report common warning symptoms such as foul smell, itching, pain, or abnormal bleeding.
Initial imaging studies revealed a suspicious mass arising from the cervix, while the uterus and ovaries appeared normal. Detailed medical history showed that the woman had never attained menarche. Previous hormonal evaluations indicated normal Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) levels. Despite well-developed secondary sexual characteristics, she had never experienced menstrual pain or urinary and bowel-related complaints.
Further evaluation at KIMS Saveera revealed that the lower end of the vagina was completely closed, making routine cervical examination and biopsy impossible. On vaginal and rectal examination, doctors detected a hard mass measuring approximately 6 × 6 cm, raising strong suspicion of malignancy. Given the diagnostic challenge, a multidisciplinary oncology team decided to proceed with definitive surgical management.
The patient underwent a radical hysterectomy along with bilateral pelvic lymph node dissection. During surgery, a fungating cervical growth measuring about 5–6 cm was identified. The ovaries and fallopian tubes were found to be normal. Examination of the uterus revealed the absence of a functional endometrial cavity, and lymph nodes showed no evidence of cancer spread.
Doctors explained that the extremely underdeveloped endometrium was the reason for the patient’s lifelong absence of menstruation. Dr. Geetha Rani clarified that this condition was not the commonly known Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, but an exceptionally rare developmental anomaly of the female reproductive system.
“The coexistence of primary amenorrhoea, an obstructed vagina, underdeveloped endometrium, and cervical cancer is extremely rare. Making a clinical decision without the possibility of biopsy was a major challenge,” Dr. Geetha Rani said.
She emphasised that the case highlights the need for heightened vigilance for gynaecological cancers even in women with congenital reproductive tract anomalies and underlined the importance of seeking care at a multidisciplinary hospital for managing such complex and rare conditions.