Cervical carcinoma

Discussion:

Bleeding in between regular cycles is ominous and needs work up. This patient visited the gynecologist who examined here and felt fullness in the posterior vaginal fornices. She took a biopsy and referred the patient for a trans vaginal ultrasound, which identified a lesion in the posterior cervix. In the meantime histopathology turned out to be poorly differntiating carcinoma probably non keratinizing squamous cell carcinoma. Adenomyotic changes are seen in the uterine body. 

Staging of cervical neoplasm is done using MRI. Non contrast three plane T2 weighted imaging is sufficient to assess local extent. Parametrial extension is assessed. Ideally 50-100 ml of ultrasound gel injected into the vagina allows better depiction of vaginal extent (not done in this case). Gadolinium use is not mandatory. 

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