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There is a 50 *60* 75 mm locally advanced bulky cervical cancer (stage IV) with marked water restriction on DWI sequence that extends downward to vagina upper half portion and involving the posterior wall of the urinary bladder.
Invasion of the mass to adjacent parametrium causing to obstruction of right lower ureter results in right-sided hydroureteronephrosis.
There are also multiple enlarged internal obturator lymph nodes, bilaterally with water restriction on DWI images suggestive for regional metastatic nodes.
In the recent case with cervical mass with regarding the imaging findings, stage IVa of cervical cancer is considered according to FIGO system staging.
The histopathology report after biopsy of cervical mass:
Innumerable irregular nests consist of malignant squamous cells invading the stroma. Laminated keratin pearls are seen within the center of the nests. Individual cells have abundant eosinophilic keratinized cytoplasm.
Dx: Squamous cell carcinoma of the cervix (keratinizing type).