The use of MRI in the diagnosis and management of a bulky cervical carcinoma Journal Article
| Authors: | Menell, J. H.; Chi, D. S.; Hann, L. E.; Hricak, H. |
| Article Title: | The use of MRI in the diagnosis and management of a bulky cervical carcinoma |
| Abstract: | Background. In the treatment of gynecologic cancer, surgical planning depends on the site and extent of disease. The evaluation of the origin of a large pelvic mass with combined pelvic examination and ultrasound is often adequate. However, the following case report illustrates the utility of magnetic resonance imaging (MRI) when sonographic findings are indeterminate and the origin of a pelvic mass is unclear. Case. A 73-year-old woman presented for her first gynecologic exam in over 40 years. On speculum examination the cervix was not visible. A large, mobile pelvic mass was palpated during physical examination. Pelvic ultrasound revealed a large, cystic pelvic mass thought to be ovarian in origin. Surgery for presumed ovarian carcinoma was planned. Because a vaginal Pap smear revealed squamous-cell carcinoma, MRI was performed for further evaluation. MRI demonstrated a blood distended uterus with a large cervical tumor obstructing the endocervical os. After cervical dilatation under sonographic guidance, evacuation of the hematometrium was performed. Multiple biopsies of the cervix confirmed the diagnosis of a bulky Stage IIA squamous-cell carcinoma of the cervix. The patient was subsequently treated with concomitant chemotherapy and radiation therapy. Follow-up MRI demonstrated an excellent treatment response. Modified radical hysterectomy was performed demonstrating very small residual tumor. Conclusions. Magnetic resonance imaging, through multiplanar capabilities and high-contrast resolution, is a valuable tool that can assist the clinician in the evaluation, diagnosis, and management of challenging gynecologic malignancies. © 2003 Elsevier Science (USA). All rights reserved. |
| Keywords: | cancer chemotherapy; treatment outcome; aged; clinical feature; anamnesis; case report; squamous cell carcinoma; cisplatin; cancer radiotherapy; radiation dose; nuclear magnetic resonance imaging; magnetic resonance imaging; ovarian neoplasms; low drug dose; diagnosis, differential; gynecological examination; evaluation; physical examination; uterine cervical neoplasms; radical hysterectomy; uterine cervix carcinoma; papanicolaou test; uterine cervix dilatation; humans; human; female; priority journal; article; specular microscopy |
| Journal Title: | Gynecologic Oncology |
| Volume: | 89 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2003-06-01 |
| Start Page: | 517 |
| End Page: | 521 |
| Language: | English |
| DOI: | 10.1016/s0090-8258(03)00143-4 |
| PUBMED: | 12798721 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work