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Carcinoma Companion Case

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This case is a companion case to the

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endometrial cancer case that I showed

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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

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than you could see on the last case right here.

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It's the other side of the cervix right here.

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So it's very similar to our last

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case of endometrial carcinoma.

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If you go to color Doppler, you can see again,

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this structure is not just blood product,

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which would also account for her vaginal

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bleeding, but it's a very hypervascular mass.

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So we talked earlier on the last

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case, when you see something like this

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centered in the cervix or lower uterine

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segment, you're thinking cervical cancer,

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you're thinking endometrial cancer.

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We'll go here to our transabdominal view,

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as you can see up here, to see the rest of the

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uterus because we couldn't see it transvaginally

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because the uterus was so enlarged.

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You can see endometrium right here.

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You can see a bit of the fundus

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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.

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Given this patient's age, however,

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endometrial cancer is going to be a lot

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less likely than a cervical cancer is.

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So we saw this, we recommended an MRI.

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I'm just going to show you

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the T2 sagittal image here.

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And you can see it, this is very

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clearly a cancer arising in the

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cervix, lower uterine segment area.

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You need a biopsy for this, and she did end up

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coming back with a cervical cancer, primary.

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And has some areas of extension

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to the bladder and to the rectum.

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So these cancers, the endometrial cancer case

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and this cervical cancer case look very, very

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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

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need that biopsy to diagnose the patient.

Report

Faculty

Kathryn McGillen, MD

Assistant Professor of Radiology, Medical Director of Ultrasound

Penn State University Milton S Hershey Medical Center

Tags

Uterus

Ultrasound

Neoplastic

MRI

Idiopathic

Gynecologic (GYN)

Cervix

CT

Body

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