A 35-year-old woman presents with postcoital bleeding. Speculum examination shows a hypertrophic, ulcerated, friable cervical lesion that bleeds on touch. Biopsy reveals epithelioid granulomas with Langhans giant cells and acid-fast bacilli. The MOST appropriate next step is:
- A Radical hysterectomy with pelvic lymphadenectomy
- B Cryotherapy of the cervix followed by review in six weeks
- C Start antitubercular therapy and reassess after completion ✓
- D Insertion of a levonorgestrel intrauterine system
Correct answer: C. Start antitubercular therapy and reassess after completion
Explanation
Hypertrophic cervical tuberculosis closely mimics carcinoma of the cervix clinically, which is why biopsy before any definitive surgery is mandatory. With granulomas and acid-fast bacilli confirmed, the lesion responds completely to a standard course of antitubercular chemotherapy, and radical hysterectomy would be unwarranted mutilating surgery. Cryotherapy treats no cause here, and hormonal therapy is irrelevant to granulomatous disease.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.