Cancer cervix - stage IIb
Cervical cancer for staging
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Huge T2 intermediate cervical mass lesion noted showing the following:
- size: 7x 7.5x 7.5 cm in maximum AP, SS and cephalocaudal dimensions respectively
- gross parametrial infiltration all around
- the lesion is filling and markedly expanding the upper vagina with focal infiltration of the posterior wall of the upper third of the vagina. Intact lower third vagina
- no extension into the pelvic sidewalls
- no ureteric infiltration nor hydronephrosis
- infiltration of the mesorectal fascia and mesorectal fat with focal loss of the fat planes posteriorly with the rectum yet no evidence of infiltration
- the urinary bladder is spared
- multiple enlarged mesorectal and presacral nodes; the largest reaching 8 mm in short axis, exhibiting diffusion restriction
- small anterior wall uterine fibroid about 15 mm
- normal MRI pattern of both adnexa
- normal marrow signal pattern of the examined pelvic girdle
Incidentally noted LV4/5 diffuse posterior disc bulge indenting the ventral thecal aspect and encroaching upon both exit foramina.
A case of cervical cancer sent for MRI staging. MRI shows gross parametrial infiltration with involvement of upper 2/3 of vagina and no sidewall pelvic extension (FIGO IIb) 1 and multiple enlarged mesorectal and presacral nodes.
Case courtesy Prof. Dr Mohamed Eid, professor of radiology, Alexandria university, Egypt.
- 1. Neerja Bhatla, Jonathan S. Berek, Mauricio Cuello Fredes, Lynette A. Denny, Seija Grenman, Kanishka Karunaratne, Sean T. Kehoe, Ikuo Konishi, Alexander B. Olawaiye, Jaime Prat, Rengaswamy Sankaranarayanan. Revised FIGO staging for carcinoma of the cervix uteri. (2019) International Journal of Gynecology & Obstetrics. 145 (1): 129. doi:10.1002/ijgo.12749 - Pubmed