Monsel's artifact in gynecologic biopsies: A simple remedy

Occasional cervical biopsies and endocervical curettage specimens show a dark-brown artifactual discoloration that may compromise diagnostic evaluation. In this work, we sought to identify the cause of this artifact and find a remedy. Positive and negative controls on test tissue were used to identify Monsel's solution (20% ferric subsulfate) as a causative agent. Perl's iron stain was used to confirm the presence of iron. Thirty affected specimens were subjected to a restitution treatment, i.e., incubation in 0.5% hydrochloric acid in 70% ethanol at 60°C for 1 h. With this restitution treatment, Monsel's artifact could be removed or significantly reduced in all cases of our series. Our restitution treatment can be used to restore diagnostic evaluability of biopsy specimens that carry a Monsel's solution-induced pigmented artifact.