The 35-year-old Massachusetts woman had a rare condition called uterine didelphys, which happens when the uterus doesn’t form properly during development and instead forms two uteruses. The woman also had two cervixes (the neck-like structure that connects the uterus to the vagina), but one vagina, which is not unusual for people with this condition.
What was unique about this woman’s case was that she contracted an HPV infection in just one of her cervixes even though both were exposed to the virus, the report said. It’s the first time that such a case has been reported.
The finding is unexpected because both cervixes must have been exposed to the same HPV virus, the doctors who treated her wrote in their report of the case. The report highlights that researchers still have more to learn about exactly why HPV sometimes lingers in the cervix, and sometimes doesn’t.
“The fact that HPV was present in one cervix while the other remained clear illustrates the complexity of HPV persistence and shedding,” the researchers, from the Lahey Hospital and Medical Center in Massachusetts, wrote in the September issue of the journal Obstetrics & Gynecology. Lingering HPV infections are a concern because they may lead to cervical cancer.
Doctors first discovered that the woman had two uteruses when she was 12 years old. At that time, she had surgery to remove a partition that separated her vagina in two, giving her a single vagina.
During a recent cervical cancer screening, the woman was found to have an HPV infection in her left cervix, along with precancerous lesions that were considered at high risk for possibly becoming cancerous. But her right cervix was free from infection and precancerous lesions.
The woman ended up undergoing treatment to remove the precancerous lesions, and by one year later, the lesions had disappeared and the woman tested negative for HPV in both cervixes.
There have been eight other reported cases of women with uterine didelphys who developed cervical cancer. In seven of those cases, the women had cancer in both of their cervixes. In one case, a woman had cervical cancer in just one cervix, but she also had a partition in her vagina, meaning that just one of her cervixes was exposed to the virus, unlike in the current case.
The new case suggests that in women with two cervixes “each cervix should undergo independent evaluation” for cervical abnormalities and HPV, the researchers said.