Presentation
Postmenopausal bleeding
Patient Data
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Large irregular polypoidal mass nearly fills the endometrial cavity, and exhibits low T1 and T2 signal with minimal surrounding fluid; it measures 33 x 32 x 53 mm (AP, ML, and CC). The mass invades and obliterates the junctional zone posteriorly, and minimally extends to the myometrium with an intact outer half of the myometrium with no MR signs of invasion. The cervical canal is clear with a preserved cervical stromal ring. No extrauterine, parametrial or vaginal invasion. No enlarged pelvic lymph nodes. Small 8 mm left external iliac node. Preserved marrow signal of the examined pelvic bones. No pelvic free fluid.
Case Discussion
Microscopic: invasive tumor of glandular structures lined by anaplastic stratified epithelium with increased mitosis. The glands are extremely crowded back to back without any intervening stroma. This carcinoma belongs to type I group. Diagnosis: adenocarcinoma, endometrioid type, grade I.
Endometrial adenocarcinoma staged Ia based on the previous findings. CT of the chest, abdomen, and pelvis was requested to complete staging.
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