To the Editor:
Giant cell arteritis (GCA) is the most common systemic vasculitis in adults, with a European and North American prevalence of 0.2%, increasing with northern latitude1,2. In contrast, gynecological vasculitis is rare3, with the first case described by Plauth in 19324. Cases are divided into localized and systemic disease. Where a systemic disorder can be identified, GCA is the most common diagnosis3.
A 79-year-old European woman presented to her general practitioner complaining of fatigue, malaise, and discomfort along the left side of her abdomen, with 2 kg weight loss. This progressed to colicky right upper-quadrant pain. A laparoscopic cholecystectomy revealed a thin-walled gall bladder with a retention mucocele. Her symptoms did not resolve and an ultrasound scan revealed a pelvic mass adjacent to the endometrium roughly 150 × 100 × 70 mm. She denied any postmenopausal bleeding and there was nothing palpable on abdominal examination. She underwent an open hysterectomy and bilateral salpingoophrectomy.
Histology revealed the pelvic mass was an edematous uterine intramural submucous …
Address correspondence to Dr. West, Auckland City Hospital, General Medicine, 2 Park Road Grafton, Auckland 1023, New Zealand; E-mail: stephenwest{at}doctors.org.uk