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Cervical polyp

Dr Praveen Jha and Radswiki et al.

A cervical polyp is a polypoid growth projecting into the cervical canal. It can be one of the most common causes of intermenstrual vaginal bleeding.

Epidemiology

Most patients are peri-menopausal at the time of presentation, especially in the 5^th decade of life.

Clinical presentation

More than half of cases are asymptomatic. Symptoms can include menorrhagia, post-menopausal bleeding, contact bleeding, and vaginal discharge. The diagnosis is made primarily with hysteroscopy.

Pathology

Histologically, cervical polypoid lesions encompass a spectrum pathologic entities which can include : endocervical or endometrial tissue with metaplasia, inflammation or malignancy, leiomyoma, or even blood clot.

The polyps are usually pedunculated, often with a slender pedicle of varying length, but some can be sessile.

Radiographic features

Endocervical polyps are usually demonstrated as masses with or without cysts filling the endocervical or vaginal canal

Complications

Can progress into carcinoma of the cervix in ~ 1% of cases

Treatment and prognosis

Surgical removal is often the treatment of choice. Usually recurrence is rare

Differential diagnosis

For a polypoid lesion within the cervical canal consider

pedunculated uterine leiomyoma protruding through the cervical canal
endometrial polyp protruding through the cervical canal

References

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1. Okamoto Y, Tanaka YO, Nishida M et-al. MR imaging of the uterine cervix: imaging-pathologic correlation. Radiographics. 23 (2): 425-45. doi:10.1148/rg.232025065 - Pubmed citation