Rangankar Varsha, Bokil Siddharth, Deshmukh Sanika
Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Pune, IND.
Cureus. 2024 Jul 5;16(7):e63931. doi: 10.7759/cureus.63931. eCollection 2024 Jul.
Squamous cell carcinomas (SCCs) are the most prevalent malignant tumors affecting the cervix. The superficial spread of SCC along the inner surface of the uterus, replacing the endometrium with malignant cells, is a rare subtype of cervical cancer. We present the case of a 55-year-old woman who complained of per-vaginal white discharge and generalized weakness for one month. Clinical examination revealed a bulky and fibrosed cervical os. A cervical biopsy confirmed the diagnosis of poorly differentiated nonkeratinizing SCC. MRI showed an endocervical infiltrative, heterogeneously enhancing mass lesion involving the cervix, along with cervical stenosis and hydrometra. Irregular thickening with nodular enhancing deposits showing morphology similar to the cervical lesion and restricted diffusion were noted along the endometrial lining contiguous with the cervical lesion. The patient underwent a radical hysterectomy, and histopathological examination revealed poorly differentiated nonkeratinizing squamous cell cervical carcinoma with contiguous squamous cell extension into the uterine endometrium, confirming the diagnosis of superficially spreading cervical SCC. Establishing the continuity of the lesion on imaging and histopathological testing is critical to confirm the presence of a superficial spread of cervical cancer and rule out contemporaneous endometrial cancer.
鳞状细胞癌(SCC)是影响子宫颈的最常见恶性肿瘤。SCC沿子宫内表面的浅表扩散,用恶性细胞取代子宫内膜,是宫颈癌的一种罕见亚型。我们报告一例55岁女性,她主诉阴道白色分泌物增多和全身乏力1个月。临床检查发现宫颈口肿大且纤维化。宫颈活检确诊为低分化非角化性SCC。MRI显示宫颈管内浸润性、不均匀强化的肿块病变累及宫颈,伴有宫颈狭窄和宫腔积脓。在与宫颈病变相邻的子宫内膜 lining 处,可见不规则增厚并伴有结节状强化沉积物,其形态与宫颈病变相似且扩散受限。患者接受了根治性子宫切除术,组织病理学检查显示为低分化非角化性宫颈鳞状细胞癌,并伴有鳞状细胞连续延伸至子宫内膜,证实了浅表扩散型宫颈SCC的诊断。在影像学和组织病理学检查中确定病变的连续性对于确认宫颈癌浅表扩散的存在并排除同期子宫内膜癌至关重要。