Presentation
Cervical cancer for staging
Patient Data
Age: 65 years
Gender: Female
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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.
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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