Background: Cervical polyp is a common tumour on the surface of cervical canal and vast majority is less than 1-2 cm. Most of cervical polyps are benign lesion, but malignant changes can occur in about 1% of cases. Giant cervical polyps are quite rare and only several cases have been presented in literature.  We present a case of giant endocervical polyp which clinically mimics cervical neoplasia.

Case Report: A 42 years old single, sexually inactive nulliparous lady with learning disability and hypertension, presented with short history of abnormal uterine bleeding and mass protruding from introitus. There were associated symptoms of discomfort and incomplete voiding. Otherwise, she denies any high-risk behavior or trauma or any history of menstrual irregularity.

Examination revealed a huge finger-like polypoidal growth measuring 8×4 cm protruded through vaginal introitus which was ulcerated and bleeding on touch.

Ultrasound examination showed a normal uterus with no evidence of adnexal mass. She was subjected for examination under anaesthesia (EUA), hysteroscopy and biopsy or excision of mass and endometrial curettage. Findings confirmed a huge polypoidal growth 6×10 cm with multiple crypts and punctum at opening and blind end (no connection with endometrial cavity). The tumour was suspected to originate from endocervical by a connecting stalk arising from antero-right lateral lip of cervix. Hysteroscopy camera successfully passed through uterine cavity, which was deviated to left and posteriorly. Findings revealed area of fluffiness over posterior wall of endometrium and hyperemic fundus with normal ostia. With all these findings suspicion of malignancy was established. Primary excision of the mass was performed at same setting and urgent histopathological examinations send.

To our surprise, the final histopathologic findings (HPE) confirmed a giant benign cervical polyp. No evidence of malignant cells or dysplasia. Patient was informed regarding findings and HPE result. Follow-up at 3 months revealed no recurrence after surgery performed.

Conclusion: Although cervical polyps are common findings, a giant polyp is rare and carcinomatous change even rare. However, size of a mass clinically can be mistaken as something sinister mimicking malignancy. Thus, biopsy and or excision of tumour for histological analysis are mandatory to confirm the rare eventuality of malignancy.