Hysteroscopic Diagnosis of a Concurrent Placental Site Nodule and Cervical Adenocarcinoma - A Case Report

Sep 30, 2026

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A 32-year-old woman undergoing routine cervical cytology screening showed atypical glandular cells. Colposcopy and biopsy identified cervical adenocarcinoma, while MRI and PET/CT showed no distant metastasis but suggested a uterine lesion suspected to be endometrial carcinoma. Hysteroscopy revealed a 15-mm white nodular lesion, and targeted biopsy suggested a placental site nodule (PSN). Cervical conization confirmed stage IA2 cervical adenocarcinoma; radical hysterectomy showed no residual carcinoma. Immunohistochemistry verified the uterine lesion as benign PSN, with no recurrence at two-year follow-up.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Abstract

Introduction

Case Presentation

Diagnostic workup

Treatment and outcomes

Review began 11/19/2025 Review ended 12/05/2025 Published 12/10/2025 © Copyright 2025 Yamazoe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98892 Open Access Case Report Hysteroscopic Diagnosis of a Concurrent Placental Site Nodule and Cervical Adenocarcinoma: A Case Report Mai Yamazoe 1, Yosuke Tarumi 2 , Sakura Yamamoto 1, Yoichiro Fujiwara 1, Taisuke Mori 2, Akemi Koshiba 1 1. Obstetrics and Gynaecology, Kyoto City Hospital, Kyoto, JPN 2. Obstetrics and Gynaecology, Kyoto Prefectural University of Medicine, Kyoto, JPN Corresponding author: Akemi Koshiba, [koshiba-a@koto.kpu-m.ac.jp](koshiba-a@koto.kpu-m.ac.jp) Abstract A 32-year-old woman presented with atypical glandular cells on cervical cytology. Her obstetric history wasgravida 2 para 2, with 23 months since her last pregnancy. Colposcopy and biopsy revealed cervical adenocarcinoma. Magnetic resonance imaging and positron emission tomography/computed tomography showed no distant spread but suggested a uterine lesion, which was suspected to be corpus uterine cancer. Hysteroscopy revealed a 15-mm white nodular lesion in the lower uterine body; biopsy suggested a placental site nodule (PSN) . Cervical conization confirmed stage IA2 cervical adenocarcinoma. The patient underwent a radical hysterectomy. Final pathology showed no residual carcinoma. The uterine lesion was confirmed as benign PSN via immunohistochemistry. She remained recurrence-free at the two-year followup. This is the first reported case of concurrent PSN and cervical adenocarcinoma. Visualization and targeted biopsy allowed accurate diagnosis of PSN, preventing overtreatment. The case highlights the diagnostic value of hysteroscopy and the importance of histological evaluation to differentiate PSN from malignancy. Categories: Obstetrics/Gynecology Keywords: case report, cervical adenocarcinoma, hysteroscopy, placental site nodule (psn), uterine cervical cancer Introduction Placental site nodule (PSN) is a rare, benign, non-neoplastic nodular lesion caused by abnormal proliferation of intermediate trophoblasts from a previous pregnancy in women of childbearing age [1] . PSN results from incomplete involution ofthe implantation site within the endometrium [2,3] . It is asymptomatic from weeks to years postpartum and often found incidentally during cervical cytology, cervical curettage, or infertility evaluation; however, it may also be detected following presentation of irregular genital bleeding oramenorrhea [2] . PSN occurs very infrequently, and its prevalence in the general population is unknown; however, recent research indicates that it may contribute to infertility and recurrent pregnancy loss [4] . As PSN occurs inside the uterus, it is important to diagnose its presence appropriately and, in some cases, distinguish it from malignant lesions. Herein, we report a case in which PSN coexisted with cervical adenocarcinoma in a patient. Despite a difficult diagnostic process, hysteroscopic biopsy enabled a preoperative diagnosis of PSN, allowing appropriate treatment for the concurrent cervical malignancy. Case Presentation A 32-year-old Japanese woman, gravida 2 para 2 (two normal vaginal deliveries), with a BMI of 25 .6 kg/m2, presented to our hospital following the detection of atypical glandular cells through cervical cytology at her annual Pap screening during a standard checkup. She had delivered her second normal full-term infant 23 months prior to the initial visit to our hospital. Her menstrual period was a regular cycle every 40 days, with no history of irregular bleeding. She had no chief complaints, past medical history, surgical history, family history, or medication history. Blood testing revealed no obvious abnormalities. Colp

FAQs

What initial finding led to further evaluation in the patient?

A cervical cytology screening detected atypical glandular cells, prompting colposcopy and biopsy.

How was the uterine lesion diagnosed before treatment?

Hysteroscopy with targeted biopsy identified the lesion as a placental site nodule (PSN), distinguishing it from suspected malignancy.

What were the final pathology results and follow-up outcome?

Final pathology showed no residual carcinoma in the uterus, and immunohistochemistry confirmed benign PSN. The patient remained recurrence-free at the two-year follow-up.

Sep 30, 2026

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