Pelvic imaging: multicystic uterine cervical lesions. can magnetic resonance imaging differentiate benignancy from malignancy?

Abstract

The malignancy potential was higher in the lesions with a higher percentage of solid components. However, determining whether multicystic lesions were benign or malignant based on the existence of solid components, the average cyst size, and the signal intensity of cyst fluid was impossible. Although a multicystic lesion with solid components in the deep cervical stroma had been reported as a MR finding of a minimal deviation adenocarcinoma, this does not appear to be pathognomonic.

Magnetic resonance imaging of adenoma malignum of the uterine cervix with pathologic correlation: a case report

“…MRI shows the most detailed features and correlates them with histologic findings. At MRI, AM is seen as a multicystic lesion with solid component invading the cervical stroma and marked hyperintensity on T2-weighted images [7]. On contrast-enhanced images, there might be enhancement of the solid component, as in cervical carcinomas, including adenocarcinomas.…”

Large multilocular cystic lesions in the uterine cervix: Differential diagnosis and significance

“…In contrast, benign lesions do not deeply invade the cervical stroma, are small size, have well-defined margins, and do not contain solid components. [ 1 2 ] However, pseudoneoplastic glandular lesions, such as uterine cervicitis, tunnel cluster, deep endocervical glands, deep nabothian cysts, endocervical hyperplasia, metaplasias, endometriosis, and infectious are benign lesions but are often histologically and radiographically confused with adenoma malignum, a malignant multilocular cystic lesions. Differentiating between adenoma malignum and pseudoneoplastic glandular lesions might be impossible and pathologic differentiation is difficult because the histopathological features of these entities are similar.…”

“…Multilocular cystic lesions in the uterine cervix can vary widely from benign to malignant because any cervical glandular proliferation can show multicystic spaces. [ 1 2 3 4 ] Differentiation between a malignant cystic lesion, such as an adenoma malignum, and a benign cystic lesion is crucial but difficult. [ 1 2 3 4 ]…”

Adenoma malignum of the uterine cervix: ultrasonographic findings in 11 patients

“…The presence on imaging studies of a multilocular lesion that invades the deep cervical stroma and contains solid components may suggest malignancy. There appears to be a continuous spectrum from hyperplasia to high‐grade malignancy, based on the percentage of solid components within a lesion18, 19. In contrast, benign lesions do not generally invade the cervical stroma deeply, are of small size with well‐defined margins and do not contain solid components1, 2, 19.…”