Pseudoterranova Infestation Beneath Uterine Serosa

A 49-year-old woman complained of genital bleeding in the follow-up period for her uterine leiomyomas. Close examination disclosed uterine corpus cancer, and biopsy confirmed endometrial carcinoma, grade 1. Total hysterectomy with bilateral salpingo-oophorectomy was performed. Just beneath the uterine serosa, a 9 x 4 mm-sized, yellowish-colored necrotic granuloma containing dead nematode was incidentally observed. Eosinophilic reaction was minimal. The worm was immunoreactive with a monoclonal antibody An-1 against Anisakis simplex antigen. Nested polymerase chain reaction using DNA extracted from formalinfixed, paraffin-embedded sections revealed a gene sequence indicative of Pseudoterranova decipiens. Pseudoterranova, a larval nematode morphologically similar to A. simplex, clinically causes anisakiasis. This is the first case of uterine anisakiasis confirmed morphologically and molecularly.