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Cervical Carcinoma
Jade Wong-You-Cheong, MBChB, MRCP, FRCR, FSRU, FSAR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Pap smear: Papanicolaou test; cervical cytology to screen for cervical neoplasia
              • Loop electrosurgical excision procedure (LEEP)
                • Allows outpatient biopsy of abnormal areas detected at colposcopy
              • Cone biopsy: Removal of cone of tissue, including transformation zone
                • Used for diagnosis (abnormal Pap smear) and therapy [cervical intraepithelial neoplasia (CIN) stage 2, 3]
              • Trachelectomy: Surgical removal of cervix, upper vagina, parametrium, pelvic lymph nodes
                • Performed in early-stage CxCA (up to stage 1B), preserves fertility

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  • Prognostic factors

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Goldberg Y et al: The added benefit of transvaginal sonography in the clinical staging of cervical carcinoma. Acta Obstet Gynecol Scand. 99(3):312-6, 2020
                                                2. Mansoori B et al: Multimodality imaging of uterine cervical malignancies. AJR Am J Roentgenol. 215(2):292-304, 2020
                                                3. Salib MY et al: 2018 FIGO staging classification for cervical cancer: added benefits of imaging. Radiographics. 40(6):1807-22, 2020
                                                4. Haldorsen IS et al: What is the role of imaging at primary diagnostic work-up in uterine cervical cancer? Curr Oncol Rep. 21(9):77, 2019
                                                5. Lee SI et al: 2018 FIGO staging system for uterine cervical cancer: enter cross-sectional imaging. Radiology. 292(1):15-24, 2019
                                                6. Dutta S et al: Image-guided radiotherapy and -brachytherapy for cervical cancer. Front Oncol. 5:64, 2015
                                                7. Koh WJ et al: Cervical cancer, Version 2. J Natl Compr Canc Netw. 13(4):395-404, 2015
                                                8. Kusmirek J et al: PET/CT and MRI in the imaging assessment of cervical cancer. Abdom Imaging. 40(7):2486-511, 2015
                                                9. Epstein E et al: Early-stage cervical cancer: tumor delineation by magnetic resonance imaging and ultrasound - a European multicenter trial. Gynecol Oncol. 128(3):449-53, 2013
                                                10. Thomeer MG et al: Clinical examination versus magnetic resonance imaging in the pretreatment staging of cervical carcinoma: systematic review and meta-analysis. Eur Radiol. 23(7):2005-18, 2013
                                                11. Mahantshetty U et al: Trans-abdominal ultrasound (US) and magnetic resonance imaging (MRI) correlation for conformal intracavitary brachytherapy in carcinoma of the uterine cervix. Radiother Oncol. 102(1):130-4, 2012
                                                12. Park SB et al: Sonographic findings of uterine cervical lymphoma manifesting as multinodular lesions. Clin Imaging. 36(5):636-8, 2012
                                                13. Sahdev A: Cervical tumors. Semin Ultrasound CT MR. 31(5):399-413, 2010
                                                14. Testa AC et al: Transvaginal ultrasonography and magnetic resonance imaging for assessment of presence, size and extent of invasive cervical cancer. Ultrasound Obstet Gynecol. 34(3):335-44, 2009
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Pap smear: Papanicolaou test; cervical cytology to screen for cervical neoplasia
                                                            • Loop electrosurgical excision procedure (LEEP)
                                                              • Allows outpatient biopsy of abnormal areas detected at colposcopy
                                                            • Cone biopsy: Removal of cone of tissue, including transformation zone
                                                              • Used for diagnosis (abnormal Pap smear) and therapy [cervical intraepithelial neoplasia (CIN) stage 2, 3]
                                                            • Trachelectomy: Surgical removal of cervix, upper vagina, parametrium, pelvic lymph nodes
                                                              • Performed in early-stage CxCA (up to stage 1B), preserves fertility

                                                          IMAGING

                                                          • General Features

                                                            • Ultrasonographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                • Prognostic factors

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Goldberg Y et al: The added benefit of transvaginal sonography in the clinical staging of cervical carcinoma. Acta Obstet Gynecol Scand. 99(3):312-6, 2020
                                                                                              2. Mansoori B et al: Multimodality imaging of uterine cervical malignancies. AJR Am J Roentgenol. 215(2):292-304, 2020
                                                                                              3. Salib MY et al: 2018 FIGO staging classification for cervical cancer: added benefits of imaging. Radiographics. 40(6):1807-22, 2020
                                                                                              4. Haldorsen IS et al: What is the role of imaging at primary diagnostic work-up in uterine cervical cancer? Curr Oncol Rep. 21(9):77, 2019
                                                                                              5. Lee SI et al: 2018 FIGO staging system for uterine cervical cancer: enter cross-sectional imaging. Radiology. 292(1):15-24, 2019
                                                                                              6. Dutta S et al: Image-guided radiotherapy and -brachytherapy for cervical cancer. Front Oncol. 5:64, 2015
                                                                                              7. Koh WJ et al: Cervical cancer, Version 2. J Natl Compr Canc Netw. 13(4):395-404, 2015
                                                                                              8. Kusmirek J et al: PET/CT and MRI in the imaging assessment of cervical cancer. Abdom Imaging. 40(7):2486-511, 2015
                                                                                              9. Epstein E et al: Early-stage cervical cancer: tumor delineation by magnetic resonance imaging and ultrasound - a European multicenter trial. Gynecol Oncol. 128(3):449-53, 2013
                                                                                              10. Thomeer MG et al: Clinical examination versus magnetic resonance imaging in the pretreatment staging of cervical carcinoma: systematic review and meta-analysis. Eur Radiol. 23(7):2005-18, 2013
                                                                                              11. Mahantshetty U et al: Trans-abdominal ultrasound (US) and magnetic resonance imaging (MRI) correlation for conformal intracavitary brachytherapy in carcinoma of the uterine cervix. Radiother Oncol. 102(1):130-4, 2012
                                                                                              12. Park SB et al: Sonographic findings of uterine cervical lymphoma manifesting as multinodular lesions. Clin Imaging. 36(5):636-8, 2012
                                                                                              13. Sahdev A: Cervical tumors. Semin Ultrasound CT MR. 31(5):399-413, 2010
                                                                                              14. Testa AC et al: Transvaginal ultrasonography and magnetic resonance imaging for assessment of presence, size and extent of invasive cervical cancer. Ultrasound Obstet Gynecol. 34(3):335-44, 2009