Presentation
Postmenopausal vagina bleeding
Patient Data
There is an enhancing soft tissue mass occupying and expanding the upper uterine endometrial cavity that shows T1W low signal intensity and T2W intermediate signal intensity relative to T2-hyperintense endometrium with restricted diffusion with suspected focal anterior myometrial invasion less than 50 %.
No extension into the cervix or beyond the uterus.
Multiple tiny cervical Nabothian cysts.
Case Discussion
Endometrial carcinoma is the most common female gynecologic malignancy. It is thought to be caused by prolonged estrogen exposure.
Specific risk factors include nulliparity, hormone replacement therapy (HRT), and tamoxifen, over 95% of endometrial carcinoma presents with postmenopausal bleeding.
The radiological findings suggestive of endometrial carcinoma are thickened endometrial with the presence of ill-defined margins separating the endometrium and the myometrium.
Staging of endometrial carcinoma is based on the International Federation of Gynecology and Obstetrics (FIGO) system, which characterizes the extent of the disease based on the involvement of the cervix, vagina, uterine serosa, adnexa, adjacent bladder/bowel, inguinal lymph nodes, and/or distant metastases.
The presence or extent of myometrial invasion is the key for staging purposes.
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