Takahashi Hiroki, Ide Risa, Narusawa Yuri, Maejima Toshitaka, Matsumura Hideyoshi
Obstetrics and Gynecology, Shinshu Ueda Medical Center, Ueda, JPN.
Pathology and Laboratory Medicine, Shinshu Ueda Medical Center, Ueda, JPN.
Cureus. 2024 Jul 4;16(7):e63808. doi: 10.7759/cureus.63808. eCollection 2024 Jul.
Superficially spreading cervical squamous cell carcinoma (SCC) is the superficial extension of SCC of the cervix into the uterine lumen, replacing the endometrium. Here, we report a case of superficially spreading cervical SCC manifesting as intrauterine mural nodules with restricted diffusion on magnetic resonance imaging (MRI). A 76-year-old woman with a history of conization presented with a pelvic mass. MRI revealed a large cystic lesion with mural nodules and wall thickening. The nodular lesions and thickened walls showed high signal intensity on diffusion-weighted imaging (DWI) and low signal intensity on apparent diffusion coefficient (ADC) maps. We performed a laparotomy for diagnosis and treatment and suspected that the tumor was of uterine origin. Hysterectomy and bilateral adnexectomy were performed. Histopathological examination revealed superficial spreading of the cervical SCC. Superficially spreading cervical SCC can manifest as intrauterine mural nodules on MRI. DWI is useful for delineating this disease. If mural nodules or endometrial thickening with restricted diffusion are found in the uterine lumen, clinicians should consider the possibility of the superficial spread of cervical SCC.
浅表扩散型宫颈鳞状细胞癌（SCC）是宫颈SCC向子宫腔内的浅表性扩展，取代了子宫内膜。在此，我们报告一例浅表扩散型宫颈SCC，在磁共振成像（MRI）上表现为子宫壁结节且扩散受限。一名有锥切史的76岁女性因盆腔肿块就诊。MRI显示一个大的囊性病变，伴有壁结节和壁增厚。结节性病变和增厚的壁在扩散加权成像（DWI）上呈高信号强度，在表观扩散系数（ADC）图上呈低信号强度。我们进行了剖腹手术以进行诊断和治疗，怀疑肿瘤起源于子宫。实施了子宫切除术和双侧附件切除术。组织病理学检查显示为宫颈SCC的浅表扩散。浅表扩散型宫颈SCC在MRI上可表现为子宫壁结节状。DWI有助于明确诊断这种疾病。如果在子宫腔内发现壁结节或扩散受限的子宫内膜增厚，临床医生应考虑宫颈SCC浅表扩散的可能性。
