Interactive Transcript
0:01
This case is a companion case to the
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endometrial cancer case that I showed
0:05
via ultrasound, except this patient is a
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29-year-old who presented with bleeding.
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And here we're focused again on the
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lower uterine segment cervix area.
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And you can see this very heterogeneous lesion.
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This one may have some calcifications within it.
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Like on this ultrasound, you can sort of see
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the splaying of the cervical tissue a bit more
0:24
than you could see on the last case right here.
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It's the other side of the cervix right here.
0:31
So it's very similar to our last
0:33
case of endometrial carcinoma.
0:35
If you go to color Doppler, you can see again,
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this structure is not just blood product,
0:41
which would also account for her vaginal
0:43
bleeding, but it's a very hypervascular mass.
0:45
So we talked earlier on the last
0:47
case, when you see something like this
0:49
centered in the cervix or lower uterine
0:50
segment, you're thinking cervical cancer,
0:52
you're thinking endometrial cancer.
0:54
We'll go here to our transabdominal view,
0:56
as you can see up here, to see the rest of the
0:58
uterus because we couldn't see it transvaginally
1:00
because the uterus was so enlarged.
1:02
You can see endometrium right here.
1:04
You can see a bit of the fundus
1:05
up here in the uterine body.
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That mass is going to be somewhere down here.
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We don't see well, but what's important
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is the endometrium up here is normal.
1:16
Given this patient's age, however,
1:18
endometrial cancer is going to be a lot
1:20
less likely than a cervical cancer is.
1:22
So we saw this, we recommended an MRI.
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I'm just going to show you
1:26
the T2 sagittal image here.
1:28
And you can see it, this is very
1:29
clearly a cancer arising in the
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cervix, lower uterine segment area.
1:34
You need a biopsy for this, and she did end up
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coming back with a cervical cancer, primary.
1:39
And has some areas of extension
1:41
to the bladder and to the rectum.
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So these cancers, the endometrial cancer case
1:46
and this cervical cancer case look very, very
1:48
similar to my eye, especially on ultrasound.
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So it really is going to be a differential
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when you see something in the cervical
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lower uterine segment area. You can use
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age of the patient to help guide you,
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but ultimately you're still going to
2:00
need that biopsy to diagnose the patient.
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