Endometrial carcinoma

Case contributed by Dr Rania Adel Anan

Presentation

Pelvic pain and intermittent vaginal bleeding.

Patient Data

Age: 70 years
Gender: Female
CT

Bulky uterus with the endometrial cavity seen distended by large heterogeneously enhancing mass. This mass is seen supplied by branches of the internal iliac arteries being more prominent on the left side. No signs of parametrial invasion were detected.

Multiple enlarged heterogeneously enhancing left para-aortic, right common iliac and bilateral external iliac lymph nodes noted.

Ultrasound

Transvaginal pelvic ultrasound demonstrating marked endometrial thickening forming a heterogeneously echogenic mass with internal vascularity on Doppler interrogation.

Case Discussion

Radiological findings are in keeping with endometrial carcinoma with nodal metastasis (FIGO IIIc) which was confirmed by histopathological examination. 

This patient was receiving antiepileptic drugs for ischemic heart disease and the long-term vaginal bleeding she experienced had been misdiagnosed as a side effect of those drugs.

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