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Aim <p>To discern between endometrial and endocervical adenocarcinomas is vital, as their management differs significantly. In cases where clinical examination and histopathology fail to establish the origin of a uterine mass, magnetic resonance imaging (MRI) plays a pivotal role. This study highlights the importance of MRI in differentiating the anatomical origin of uterine masses.</p> Method <p>We present a comprehensive analysis of four patients with uterine masses of deceptive origin, whose MRI was performed on a 3&#xa0;T GE scanner. The imaging parameters studied were the site of highest tumour involvement/tumour epicentre (uterine body or cervix), shape and pattern of growth (perpendicular or parallel to the long axis of the uterus), the extent of locoregional spread, signal intensity characteristics and the pattern of enhancement on DCE imaging. Postoperative histopathological (HPE) reports were obtained for each case to confirm the definitive diagnosis.</p> Results <p>The endocervical cancers typically showed perpendicular growth to the long axis of the uterus and prior parametrial invasion. In contrast, endometrial cancers were parallel to the long axis of the uterus and had prior myometrial invasion. We found that the site of highest tumour involvement/tumour epicentre and the enhancement pattern on early phase DCE scans were the two most important features for accurate differentiation.</p> Conclusion <p>MRI is pivotal in differentiating endometrial and endocervical adenocarcinomas, further substantiated by HPE confirmation and guiding therapeutic decisions.</p>

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Differentiating Endometrial vs Endocervical Carcinoma: MRI-Based Case Review

  • 期刊论文

  • 发表日期：

    2025年6月16日

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  • Ruchika Mohan,
  • Aanchal Bhayana,
  • Neha Bagri,
  • Ritu Misra

摘要

Aim

To discern between endometrial and endocervical adenocarcinomas is vital, as their management differs significantly. In cases where clinical examination and histopathology fail to establish the origin of a uterine mass, magnetic resonance imaging (MRI) plays a pivotal role. This study highlights the importance of MRI in differentiating the anatomical origin of uterine masses.

Method

We present a comprehensive analysis of four patients with uterine masses of deceptive origin, whose MRI was performed on a 3 T GE scanner. The imaging parameters studied were the site of highest tumour involvement/tumour epicentre (uterine body or cervix), shape and pattern of growth (perpendicular or parallel to the long axis of the uterus), the extent of locoregional spread, signal intensity characteristics and the pattern of enhancement on DCE imaging. Postoperative histopathological (HPE) reports were obtained for each case to confirm the definitive diagnosis.

Results

The endocervical cancers typically showed perpendicular growth to the long axis of the uterus and prior parametrial invasion. In contrast, endometrial cancers were parallel to the long axis of the uterus and had prior myometrial invasion. We found that the site of highest tumour involvement/tumour epicentre and the enhancement pattern on early phase DCE scans were the two most important features for accurate differentiation.

Conclusion

MRI is pivotal in differentiating endometrial and endocervical adenocarcinomas, further substantiated by HPE confirmation and guiding therapeutic decisions.