Endometrial adenocarcinoma

Case contributed by Dr Sigmund Stuppner

Presentation

Intermittent menometrorrhagia.

Patient Data

Age: 55 years
Gender: Female

Pelvis

MRI

Sagittal T2WI: Intermediate signal intensity mass in the endometrial cavity.

Axial T1WI: Isointense mass to the myometrium.

Sagittal DWI with b=1000: Evident diffusion restriction.

Sagittal ADC: Low signal - true diffusion restriction.

Sagittal T1 C+ fat sat: Mass shows typical low signal.

Additional findings are three uterine fibromyomas with typical low signal in T2 and Nabothian cysts in the cervix uteri.

Case Discussion

The endometrial carcinoma in this case does not infiltrate the myometrium significantly; that is, infiltration is below 50% of the myometrial thickness. This finding is compatible with FIGO (2009) stage Ia.

Endometrial carcinoma is one of the most common gynecological malignancies. Imaging plays an important role in that it enables the gynecologist and oncologist to decide on the best therapy.

In this case, the patient was treated with laparoscopic hysterectomy and bilateral salpingo-oophorectomy. The histopathological findings after surgery confirmed an endometrial adenocarcinoma, endometrioid type, with invasion of less than half of the myometrial thickness (TNM stage pT1a NX MX G2 R0 V0 L1).

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