GIANT-CELL ARTERITIS OF THE UTERUS - CASE-REPORT AND REVIEW

We here report a rare case of giant cell arteritis (GCA) of the myomet rium found incidentally in a 68-year-old Caucasian woman presenting wi th uterovaginal prolapse and a known past history of temporal arteriti s/polymyalgia rheumatica. Histology revealed a segmental arteritis of small, medium and some quite large myometrial arteries with extensive destruction of both internal and external elastic laminae. Multinuclea te giant cells, lymphocytes and histiocytes were most prominent in the inflammatory infiltrate. The findings in this case are compared with previous reports, In a review of the literature it was found that almo st one third of cases presented with generalised symptoms such as feve r, anemia, fatigue and weight loss. The symptoms were not immediately recognised as temporal arteritis or polymyalgia rheumatica. On routine physical examination or radiological investigation, benign gynecologi cal pathology such as a simple ovarian cyst or uterine leiomyoma were found. The subsequent unexpected discovery of GCA on histological exam ination was the critical event in alerting clinicians to the diagnosis of temporal arteritis/polymyalgia rheumatica. Without exception stero id therapy was successful in achieving relief of generalised symptoms.