Cancer cervix - stage IIb

Case contributed by Dr Mostafa El-Feky

Presentation

Cervical cancer for staging

Patient Data

Age: 65 years
Gender: Female
MRI

Pelvis

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.

Case Discussion

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.

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Case information

rID: 75411
Published: 9th May 2020
Last edited: 11th May 2020
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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