Endometrial carcinoma

Case contributed by Dr Shailaja Muniraju

Presentation

Bleeding per vagina.

Patient Data

Age: 70 years
Gender: Female
Modality: Ultrasound

The endometrial cavity appears to be distended with heterogeneous mass and this mass shows internal vascularity.

Modality: MRI

Uterus shows changes of post menopausal atrophy

  • There is a 3.5 x 3.0 x 2.4cms (Vol – 14cc) sized mass lesion (T1 iso and T2 hypointense) seen distending the endometrial cavity. Furthermore, it appears to invades more than 50 percentage of the myometrium. However, the outer band of myometrium is continuous. Restriction seen on ADC/DWI images.
  • No extension into the cervix or beyond uterus.
  • No bladder / rectal involvement.
  • No suspicious lymph nodes.

Both ovaries are of low volume, in keeping with post menopausal atrophy. No focal lesions seen.

No free fluid is seen.

Special thanks: Dr Madan Mohan Babu.

The patient underwent total hysterectomy with bilateral salpingo-oophorectomy and bilateral pelvic lymph node dissection.

Intraoperative findings: tumor was involving he posterior wall of endometrium and the right ovary was adherent to posterior surface of uterus. It showed a small cyst containing sebaceous material. 

Histopathology

Endometrioid adenocarcinoma with squamous differentiation. FIGO grade 1. Myometrial invasion was less than half. No lymphovascular invasion. Examined pelvic nodes were free of tumor.

Case Discussion

This is a proven case of FIGO stage 1a endometrial adenocarcinoma.

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Case Information

rID: 50767
Case created: 20th Jan 2017
Last edited: 21st Jan 2017
Inclusion in quiz mode: Included

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