EURORAD ESR

Case 14692

Epithelioid sarcoma of the uterine cervix

Author(s)
Tonolini Massimo, MD.

"Luigi Sacco" University Hospital,
Radiology Department;
Via G.B. Grassi 74
20157 Milan, Italy;
Email:mtonolini@sirm.org
 
Patient
female, 52 year(s)
 
 
  • Figure 1
    Initial pelvic MRI (limited noncontrast protocol because of claustrophobia)
     

    Sagittal (a), axial (b) T2-weighted images showed moderate-to-high signal intensity mass (*) at lower cervix (3 cm craniocaudal diameter), which obliterated the vaginal fornices. Note spared upper cervix, normal-sized...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial (b & fat-suppressed c) T2-weighted images confirmed predominantly exophytic lower cervical mass (*) with moderate-to-high signal intensity, 52x36mm axial diameters, thinned disrupted outer stroma consistent with...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial (b & fat-suppressed c) T2-weighted images confirmed predominantly exophytic lower cervical mass (*) with moderate-to-high signal intensity, 52x36mm axial diameters. Note absent pelvic lymphadenopathies and...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    On precontrast T1-weighted images the lower cervical exophytic mass (*) showed solid-type intermediate signal intensity. Note absent pelvic lymphadenopathies and effusion in peritoneal cul-de-sac.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    High (800) b-value diffusion-weighted images (e) showed visually hyperintense signal in the lobulated, well demarcated lower cervical mass (*), reflecting restricted diffusion, with low signal on corresponding...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    In the apparent diffusion coefficient (ADC) map the lobulated lower cervical mass (*) showed low signal from restricted diffusion, with measured ADC values of approximately 0.70-0.75x10-3 mm2/s in its peripheral...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Follow-up unenhanced MRI after radiotherapy (interrupted due to claustrophobia)

    Limited to axial T2-weighted images because of claustrophobia, repeated MRI showed stable size and thickness of lower cervical mass (*) compared to Fig. 1, without lymphadenopathies and peritoneal effusion.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
Sagittal (a), axial (b) T2-weighted images showed moderate-to-high signal intensity mass (*) at lower cervix (3 cm craniocaudal diameter), which obliterated the vaginal fornices. Note spared upper cervix, normal-sized uterine body and fundus.
 
Axial (b & fat-suppressed c) T2-weighted images confirmed predominantly exophytic lower cervical mass (*) with moderate-to-high signal intensity, 52x36mm axial diameters, thinned disrupted outer stroma consistent with parametrial infiltration.
 
Axial (b & fat-suppressed c) T2-weighted images confirmed predominantly exophytic lower cervical mass (*) with moderate-to-high signal intensity, 52x36mm axial diameters. Note absent pelvic lymphadenopathies and effusion in peritoneal cul-de-sac.
 
On precontrast T1-weighted images the lower cervical exophytic mass (*) showed solid-type intermediate signal intensity. Note absent pelvic lymphadenopathies and effusion in peritoneal cul-de-sac.
 
High (800) b-value diffusion-weighted images (e) showed visually hyperintense signal in the lobulated, well demarcated lower cervical mass (*), reflecting restricted diffusion, with low signal on corresponding apparent diffusion coefficient (ADC) map (f).
 
In the apparent diffusion coefficient (ADC) map the lobulated lower cervical mass (*) showed low signal from restricted diffusion, with measured ADC values of approximately 0.70-0.75x10-3 mm2/s in its peripheral portions.
 
Limited to axial T2-weighted images because of claustrophobia, repeated MRI showed stable size and thickness of lower cervical mass (*) compared to Fig. 1, without lymphadenopathies and peritoneal effusion.
 
 
 
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