Presentation
Intermittent painless vaginal bleeding.
Patient Data
Age: 45 years
Gender: Female
From the case:
Cervical carcinoma - stage IIIC1
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A huge T2 intermediate signal intensity bulky circumferential cervical mass lesion with marked water restriction shows the following:
- size: 5 x 9 x 9.5 cm
- parametrial infiltration with small focal disruptions of the normal low T2 cervical rim
- the lesion is filling and markedly expanding the upper two-thirds of the vagina; intact lower third vagina
- no extension into the pelvic sidewalls
- no ureteric infiltration nor hydronephrosis
- no infiltration of the mesorectal fascia
- spared urinary bladder
- few enlarged bilateral internal iliac chains regional lymph nodes with diffusion restriction suggestive of metastatic nodes; the largest reaching 22 mm in short axis with a necrotic centre on the right side
- uterus few small intramural myomas with maximum diameters up to 20mm
- uterus endometrial cavity mass with intermediate signal intensity measuring about 15 x 30 mm inferring endometrial polyp (confirmed on US exam)
- fluid equivalent signal cystic lesions measuring about 45 x 60 mm and 40 x 55 mm at the left and right ovaries respectively
- normal marrow signal pattern of the pelvic bones
- no distance metastasis
Case Discussion
Stage IIIC1 of cervical cancer is considered according to FIGO system staging. The histopathology report after biopsy of cervical mass: squamous cell carcinoma of the cervix.