Squamous cell carcinoma of the cervix
Vaginal bleeding in a postmenopausal woman. Gynecological speculum examination revealed a 3 cm mass in the cervix. Biopsy was performed. Exam requested for local staging.
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Technique: Axial images were obtained through the abdomen (not shown) and pelvis after the oral contrast administration and after endovenous contrast (portal venous and renal excretory phases. Multiplanar reconstructions were also done.
Findings: There is a heterogeneously enhancing mass involving the cervix, measuring 6.8 x 3.5 x 4.5 cm (Long x AP x T), with no clear limits with the proximal vaginal walls and the posterior aspect of the bladder wall. A thin layer of fat tissue seems to separate the mass from the anterior wall of the rectum. The body of the uterus shows a distended endometrium cavity surrounded by a thin myometrium wall. There are no enlarged lymph nodes. No free fluid in the pelvis. The remainder exam is unremarkable.
Conclusion: A large mass involving the cervix with no clear limits on the posterior aspect of the bladder. MRI study can help in spotting a possible local invasion.
Unfortunately, in many places in the world, access to MRI exams is still difficult. As a way to not delay treatment, oncologists request pelvis CT for a local staging of some gynecological tumours.
This case was confirmed by the biopsy as a squamous cell carcinoma of the cervix.