Diffusion-Weighted Magnetic Resonance Imaging to Detect Synchronous Uterine Endometrial and Endocervical Adenocarcinoma

Carvalho, Jesus Paula; Viana, Públio César Cavalcante; Antón, Cristina; Favero, Giovanni; Silva, Alexandre Silva e; Baracat, Edmund Chada; Carvalho, Filomena Marino

doi:10.4081/rt.2012.e19

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…6 Endocervical adenocarcinoma though rare when associated with an endometrial adenocarcinoma can be difficult to identify due to overlapping morphological features. 5 Immunohistochemistry plays an important role in making this distinction. Endometrioid adenocarcinoma is ER/PR positive, p16 negative, CEA negative and vimentin positive.…”

Section: Discussionmentioning

confidence: 99%

“…4 Another neoplasm that can present with bleeding and has similar morphology in the uterus is endocervical carcinoma which can sometimes be picked up by cervical smear screening. 4,5 Presence of synchronous endometrial and cervical cancer is quite rare, with usual association being with ovarian cancer rather than cervical. 6 We present a case of incidental detection of synchronous endometrial and endocervical carcinoma who presented with complaints of alopecia and hirsutism.…”

Section: Introductionmentioning

confidence: 99%

“…4 Another neoplasm that can present with bleeding and has similar morphology in the uterus is endocervical carcinoma which can sometimes be picked up by cervical smear screening. 4,5…”

Section: Introductionmentioning

confidence: 99%

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How hairfall saved the patient from cancer twice – A postmenopausal patient with synchronous endometrial and endocervical carcinomas presenting with endocrine symptoms

et al. 2023

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Ovarian stromal hyperthecosis is an uncommon nonneoplastic cause of ovarian hyperandrogenism mainly in postmenopausal women. Here, we present a case of a postmenopausal woman who presented with features of virilization like alopecia and hirsutism. During its workup, two malignancies were diagnosed at a very early stage. Microscopic focus of endometrial adenocarcinoma in a polyp and similar focus of endocervical adenocarcinoma in the subsequent hysterectomy specimen were noted. Presence of synchronous malignancies in the uterus is very rare and it being detected in a patient who presented with a non-related symptom of hairfall makes it an interesting case scenario.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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How hairfall saved the patient from cancer twice – A postmenopausal patient with synchronous endometrial and endocervical carcinomas presenting with endocrine symptoms

et al. 2023

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Diagnostic significance of diffusion-weighted MRI in patients with cervical cancer: a meta-analysis

et al. 2014

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The aim of this meta-analysis is to demonstrate whether diffusion-weighted magnetic resonance imaging (DWI) could assist in the precise diagnosis of cervical cancer or not. Both English and Chinese electronic databases were searched for potential relevant studies followed by a comprehensive literature search without any language restriction. Two reviewers independently assessed the methodological quality of the included trials. Standardized mean difference (SMD) and its corresponding 95 % confidence interval (95 % CI) were calculated in this meta-analysis. We chose Version 12.0 STATA statistical software to analyze our statistical data. Thirteen eligible cohort studies were selected for statistical analysis, including 645 tumor tissues and 504 normal tissues. Combined SMD of apparent diffusion coefficient (ADC) suggested that the ADC value in cervical cancer tissues was significantly lower than that of normal tissue (SMD = 2.80, 95 % CI = 2.64 ~ 2.96, P < 0.001). Subgroup analysis stratified by ethnicity indicated a higher ADC value in the normal tissues compared to the cancer tissues in both the Asian and Caucasian subgroups (Asians: SMD = 2.83, 95 % CI = 2.64 ~ 3.02, P < 0.001; Caucasians: SMD = 2.73, 95 % CI = 2.45 ~ 3.01, P < 0.001, respectively). The results from the subgroup analysis by MRI machine type revealed a statistically significant difference in ADC value between normal cervical tissue and tumor tissues among all of the six MRI machine type subgroups (all P < 0.05). The main finding from our meta-analysis revealed that increased signal intensity on DWI and decreased signal on ADC seem to be useful in the diagnosis of cervical cancer. DWI could therefore be an important imaging tool in potentially identifying patients with cervical cancer.

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Role of MRI in diagnosing the primary site of origin in indeterminate cases of uterocervical carcinomas: a systematic review and meta-analysis

Jain

Aggarwal

Ghasi

et al. 2021

The British Journal of Radiology

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Objective: To perform a literature review assessing role of MRI in predicting origin of indeterminate uterocervical carcinomas with emphasis on sequences and imaging parameters. Methods: Electronic literature search of PubMed was performed from its inception until May 2020 and PICO model used for study selection; population was female patients with known/clinical suspicion of uterocervical cancer, intervention was MRI, comparison was by histopathology and outcome was differentiation between primary endometrial and cervical cancers. Results: Eight out of 9 reviewed articles reinforced role of MRI in uterocervical primary determination. T2 and Dynamic contrast were the most popular sequences determining tumor location, morphology, enhancement, and invasion patterns. Role of DWI and MR spectroscopy has been evaluated by even fewer studies with significant differences found in both apparent diffusion coefficient values and metabolite spectra. The four studies eligible for meta-analysis showed a pooled sensitivity of 88.4% (95% confidence interval 70.6 to 96.1%) and a pooled specificity of 39.5% (95% confidence interval 4.2 to 90.6%). Conclusions: MRI plays a pivotal role in uterocervical primary determination with both conventional and newer sequences assessing important morphometric and functional parameters. Socioeconomic impact of both primaries, different management guidelines and paucity of existing studies warrants further research. Prospective multicenter trials will help bridge this gap. Meanwhile, individual patient database meta-analysis can help corroborate existing data. Advances in knowledge: MRI with its classical and functional sequences helps in differentiation of the uterine ‘cancer gray zone’ which is imperative as both primary endometrial and cervical tumors have different management protocols.

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Diffusion-Weighted Magnetic Resonance Imaging to Detect Synchronous Uterine Endometrial and Endocervical Adenocarcinoma

Cited by 3 publications

References 13 publications

How hairfall saved the patient from cancer twice – A postmenopausal patient with synchronous endometrial and endocervical carcinomas presenting with endocrine symptoms

How hairfall saved the patient from cancer twice – A postmenopausal patient with synchronous endometrial and endocervical carcinomas presenting with endocrine symptoms

Diagnostic significance of diffusion-weighted MRI in patients with cervical cancer: a meta-analysis

Role of MRI in diagnosing the primary site of origin in indeterminate cases of uterocervical carcinomas: a systematic review and meta-analysis

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