Acute cervicitis resembling gastric-type mucinous adenocarcinoma that was definitively diagnosed by cervical conization: A case report.
Radiol Case Rep
; 18(5): 1767-1771, 2023 May.
Article
em En
| MEDLINE
| ID: mdl-36923387
ABSTRACT
Although imaging studies are not typically performed for clinical diagnosis of cervicitis, in this case magnetic resonance imaging (MRI) was performed because a lesion with a tumor-like gross appearance was found in the uterine cervix. We present a case of cervicitis in which clinical, imaging and pathological features overlapped with those of gastric-type mucinous adenocarcinoma (GAS). The patient, a 30-year-old woman, was referred to a gynecologist with a complaint of watery vaginal discharge. On visual examination, the uterine cervix was irregularly enlarged and bled easily, suggesting cervical cancer. The next day, the patient had a fever of 39°C and blisters appeared on her vulva due to herpes simplex virus type II infection. MRI showed a diffusely enlarged cervix with poorly marginated high signal intensity on T2-weighted imaging (WI) and apparent diffusion coefficient map as well as strong enhancement on contrast-enhanced T1WI, which are findings consistent with GAS. Although a punch biopsy showed only mild atypia of the cervical glands, this was not enough to completely rule out GAS. Consequently, laser conization of the lesion was performed for definitive diagnosis, and the diagnosis of cervicitis was made. Acute cervicitis can be difficult to differentiate from GAS based on symptoms, results of cervical biopsy and MR imaging because of their overlapping features. Even when a patient presents with a lesion with tumor-like gross appearance, acute cervicitis should be included in the differential diagnosis if the result of cervical biopsy is negative, especially when accompanied by infection-like fever.
ADC, apparent diffusion coefficient; Adenocarcinoma; DWI, diffusion-weighted imaging; Diagnostic Imaging; FDG, fluorodeoxyglucose; G, gravida; GAS, gastric-type mucinous adenocarcinoma; HSV, herpes simplex virus; MRI, magnetic resonance imaging; Magnetic Resonance Imaging; Mucinous; P, para; PET-CT, positron emission tomography-computed tomography; Positron-Emission Tomography; STD, sexually transmitted disease; TE, echo time; TR, repetition time; Uterine Cervicitis; WI, weighted imaging
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Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
Idioma:
En
Revista:
Radiol Case Rep
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Japão