Case Report

Giant Cell Arteritis of the Female Genital Tract: Report of a Case and Review of the Literature

Authors: Rahul K. Patel, MD, Kelley Carrick, MD

Abstract

A 65-year-old female presented with constitutional symptoms of fever and weight loss with bilateral adnexal masses on physical examination. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed and subsequently revealed giant cell arteritis involving numerous small arteries in the ovaries, fallopian tubes, paraovarian and paratubal soft tissues, myometrium, and cervix. After surgery, the patient continued to have constitutional symptoms. Corticosteroid therapy led to a significant improvement and eventual resolution of symptoms. Several similar cases of giant cell arteritis of the female genital tract have been described, both with and without concomitant temporal arteritis. Implications for diagnosis and treatment are discussed.


Key Points


* Giant cell arteritis of the female genital tract is a rare vasculitis affecting postmenopausal women, often discovered incidentally.


* Concomitant temporal arteritis or polymyalgia rheumatica is described in the majority of reported cases of giant cell arteritis of the female genital tract.


* Giant cell arteritis of the female genital tract may present in postmenopausal women with constitutional symptoms and genital tract lesions on imaging, as was the case in our patient.

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References

1. Schoen FJ, Cotran RS. Blood vessels, in Cotran RS, Kumar V, Collins T (eds): Robbins Pathologic Basis of Disease. 6th ed. Philadelphia, WB Saunders Co, 1999, pp 517–519.
 
2. Medvedev G, Al-Shamari AE, Copland MA, Magil AB. Isolated renal giant cell arteritis. Am J Kidney Dis 2002;40:658–661.
 
3. Polasky N, Polasky SH, Magenheim H, Abrams NR. Giant-cell arteritis: review and report of case.JAMA 1965;191:341–343.
 
4. Ormsby AH, Haskell R. Giant cell arteritis of the uterus: case report and review. Pathology1997;29:227–230.
 
5. Orbo A, Steffensen A. Endometrial cancer, vasculitis of the genital tract and occult temporal arteritis.Histopathology 2001;38:178–179.
 
6. Paccalin M, Le Moal G, Roblot P. Giant-cell arteritis of the female genital tract. Ann Intern Med2001;134:626–627.
 
7. Birch PJ, Buchanan R. A gynaecological complication of polymyalgia rheumatica/giant cell arteritis.Br J Obstet Gynaecol 1989;96:1356–1358.
 
8. Evans CE, Flight GH, Neufeld VR, Muckle TJ. Giant cell arteritis of uterus and adnexa. Paroi Arterielle 1980;6:27–33.
 
9. Inanc M, Gul A, Tuzlali S, et al. Female genital tract giant cell arteritis associated with occult temporal arteritis. J Rheumatol 1996;23:393–395.
 
10. Kohn NN. Giant cell arteritis of the female reproductive tract associated with temporal arteritis. J Rheumatol 1989;16:832–833.
 
11. Lhote F, Mainguene C, Griselle-Wiseler V, et al. Giant cell arteritis of the female genital tract with temporal arteritis. Ann Rheum Dis 1992;51:900–903.
 
12. Marrogi AJ, Gersell DJ, Kraus FT. Localized asymptomatic giant cell arteritis of the female genital tract. Int J Gynecol Pathol 1991;10:51–58.
 
13. Bell DA, Mondschein M, Scully RE. Giant cell arteritis of the female genital tract: a report of three cases. Am J Surg Pathol 1986;10:696–701.