CERVICAL CARCINOMA
History:
Elderly female presents with postmenopausal vaginal bleeding and pelvic pain. The patient is referred for ultrasound evaluation of the pelvis for suspected cervical malignancy.
Ultrasound Findings and Description:
- An enlarged, heterogeneous mass lesion involving both lips of cervix and vaginal walls is seen.
- It is hypoechoic with irregular borders.
- Increased vascularity noted within the mass on color Doppler imaging, indicative of neovascularization.
- The mass appears to invade the parametrium but no definitive bladder or rectal involvement noted.
- Normal appearance of the endometrium. Ovaries are not well visualized, consistent with postmenopausal status. No free fluid in the pelvis.
Diagnosis: Carcinoma of the cervix, likely invasive cervical carcinoma.
Differential Diagnosis:
- Cervical Polyp: These can present as focal cervical masses but are usually well-defined, without aggressive features or vascularity.
- Cervical Fibroid (Leiomyoma): A rare possibility in this location, cervical fibroids are well-defined and more homogeneous compared to the findings in this case.
Conclusions:
- Large, hypoechoic cervical mass with irregular borders and hypervasculaity suggestive of cervical carcinoma.
- Further evaluation with biopsy and advanced imaging (MRI pelvis) is recommended to assess local invasion and staging.
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