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المستخلص
Carcinoma of the uterine cervix and endometrium are common gynecologic malignancies. Both carcinomas are staged and managed by means of the International Federation of Gynecology and Obstetrics (FIGO) staging system. Although this system is effective for early stage disease, it has inherent inaccuracies in advanced stage diseases and does not address nodal involvement.
Both cervical and endometrial adenocarcinoma can present clinically as a cervical mass. The anatomic site of origin of the tumor may not always be clinically apparent. The treatment options for endometrial adenocarcinoma differ from those for cervical adenocarcinoma. Patients with endometrial carcinoma usually undergo surgery for most stages of the disease and may receive adjuvant radiation therapy. Conversely patients with primary cervix cancer with bulky Stage IB, adenopathy, or Stage II or greater disease undergo primary radiation therapy or combined chemotherapy and radiation therapy without surgery. MR imaging is expected to greatly optimize surgical procedure and therapeutic strategy.
Differentiating between endocervical and endometrial adenocarcinoma in small pre-operative endocervical and endometrial specimens may be difficult: endometrial adenocarcinomas may involve the endocervix and endocervical neoplasms may be sampled en-route to the endometrial cavity, and primary tumours at both of these sites may show histological similarities.
Because there is some overlap in the distinguishing imaging features between the two primary sites, we suggest repeat biopsy or pathologic review in cases that have a discrepancy between the clinical diagnosis and the MRI diagnosis of site of origin. Further prospective studies are required to determine whether this is a valid approach.