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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research MEDICINUS
Riyan Hari Kurniawan
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Unmasking the Culprit: Successful Restoration of Menstrual Function in a Case of Secondary Amenorrhea Due to Tuberculous Endometritis Mimicking Polycystic Ovary Syndrome Riyan Hari Kurniawan; Muhammad Syauqi Mirza; Ilham Utama Surya; Muhammad Dwi Priangga; Cepi Teguh Pramayadi; Herbert Situmorang; Eka Rusdianto Gunardi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1390

Abstract

Background: Secondary amenorrhea presents a significant diagnostic challenge in gynecology. While Polycystic Ovary Syndrome (PCOS) is a common cause, rare etiologies like tuberculous endometritis can be overlooked, especially in patients with features suggestive of PCOS. This phenomenon, known as diagnostic overshadowing, can lead to delayed diagnosis and irreversible reproductive consequences. Case presentation: A 35-year-old nulligravid woman with a diagnosis of Class I Obesity presented with a five-year history of secondary amenorrhea and a desire for fertility. Her clinical and initial ultrasonographic findings were suggestive of PCOS. However, persistent amenorrhea despite hormonal therapy prompted further investigation. Hysteroscopy revealed a fibrotic uterine cavity with micropolyps, and subsequent endometrial biopsy with histopathology, polymerase chain reaction (PCR), and culture confirmed a diagnosis of tuberculous endometritis. The patient was successfully treated with a six-month anti-tuberculosis regimen, cyclical progestin therapy, and a structured lifestyle modification program. Following treatment, she experienced a significant weight loss, resumption of regular menstrual cycles, and marked improvement in endometrial and ovarian ultrasound parameters. Conclusion: This case underscores the critical importance of a comprehensive diagnostic evaluation for secondary amenorrhea, including endometrial sampling, even when a common diagnosis like PCOS is suspected. It highlights the potential for tuberculous endometritis to mimic PCOS and demonstrates the efficacy of a multidisciplinary approach in restoring menstrual and potentially reproductive function. Clinicians in tuberculosis-endemic regions must maintain a high index of suspicion for this insidious pathology to prevent long-term morbidity.
Unmasking the Culprit: Successful Restoration of Menstrual Function in a Case of Secondary Amenorrhea Due to Tuberculous Endometritis Mimicking Polycystic Ovary Syndrome Riyan Hari Kurniawan; Muhammad Syauqi Mirza; Ilham Utama Surya; Muhammad Dwi Priangga; Cepi Teguh Pramayadi; Herbert Situmorang; Eka Rusdianto Gunardi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1390

Abstract

Background: Secondary amenorrhea presents a significant diagnostic challenge in gynecology. While Polycystic Ovary Syndrome (PCOS) is a common cause, rare etiologies like tuberculous endometritis can be overlooked, especially in patients with features suggestive of PCOS. This phenomenon, known as diagnostic overshadowing, can lead to delayed diagnosis and irreversible reproductive consequences. Case presentation: A 35-year-old nulligravid woman with a diagnosis of Class I Obesity presented with a five-year history of secondary amenorrhea and a desire for fertility. Her clinical and initial ultrasonographic findings were suggestive of PCOS. However, persistent amenorrhea despite hormonal therapy prompted further investigation. Hysteroscopy revealed a fibrotic uterine cavity with micropolyps, and subsequent endometrial biopsy with histopathology, polymerase chain reaction (PCR), and culture confirmed a diagnosis of tuberculous endometritis. The patient was successfully treated with a six-month anti-tuberculosis regimen, cyclical progestin therapy, and a structured lifestyle modification program. Following treatment, she experienced a significant weight loss, resumption of regular menstrual cycles, and marked improvement in endometrial and ovarian ultrasound parameters. Conclusion: This case underscores the critical importance of a comprehensive diagnostic evaluation for secondary amenorrhea, including endometrial sampling, even when a common diagnosis like PCOS is suspected. It highlights the potential for tuberculous endometritis to mimic PCOS and demonstrates the efficacy of a multidisciplinary approach in restoring menstrual and potentially reproductive function. Clinicians in tuberculosis-endemic regions must maintain a high index of suspicion for this insidious pathology to prevent long-term morbidity.
Diagnostic Dilemma in Massive Cellular Leiomyoma with Cystic Degeneration Arya Ady Nugroho; Riyan Hari Kurniawan; Aprilia Asthasari Siregar
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qkhd0b31

Abstract

Background: Uterine leiomyomas, commonly known as fibroids, are prevalent benign tumors in women of reproductive age. While often asymptomatic, they can become symptomatic when they enlarge or when degenerative changes occur. Cystic degeneration, which occurs in approximately 4% of leiomyomas, presents a diagnostic challenge, as it can mimic malignancy on imaging due to its solid-cystic appearance on imaging. This case report aims to highlight the diagnostic dilemma posed by large leiomyomas with cystic degeneration and to emphasize the importance of advanced imaging as well as histopathological examination in confirming benign diagnoses and excluding malignancy. Case Presentation: A 27-year-old woman presented with progressive abdominal distension and intermittent lower abdominal pain over thepast year. Imaging revealed a large, solid-cystic mass in the uterine fundus, raising suspicion of malignancy. Further diagnostic workup, including magnetic resonance imaging (MRI) and histopathological examination, confirmed the massas a benign leiomyoma with cystic degeneration. The patient underwent a laparotomy myomectomy, and intraoperative findings confirmed a well-circumscribed subserosal mass with cystic degeneration. Histopathology examination alsoconfirmed a benign leiomyoma, ruling out malignancy. Conclusion: This case underscores the diagnostic challenges of differentiating large leiomyomas with cystic degeneration from malignancies. Advanced imaging, particularly MRI, along with histopathological examination, plays a crucial role in establishing an accurate diagnosis and subsequently, guiding appropriate management.
Co-Authors Aprilia Asthasari Siregar Arya Ady Nugroho Cepi Teguh Pramayadi Eka Rusdianto Gunardi Herbert Situmorang Herbert Situmorang Ilham Utama Surya Muhammad Dwi Priangga Muhammad Syauqi Mirza