MRI helps reveal rare spread of cervical cancer into the uterine corpus

“MRI demonstrated the standard findings of superficial unfold in our affected person, with a hyperintense lesion on DWI within the endocervical area and corresponding low sign depth on the ADC map.”

BUFFALO, NY — September 2, 2026 — A brand new case report was printed in Volume 13 of Oncoscience on July 29, 2026, titled “MRI in deciphering the superficial spread of cervical squamous cell carcinoma into the uterine corpus: A case report and literature review.”

The report was led by first writer Naina Kumar from the Department of Obstetrics and Gynecology at the All India Institute of Medical Sciences (AIIMS), Bibinagar, Hyderabad, Telangana, India. The corresponding writer, Aparna Jarathi, is from the identical division. 

Cervical squamous cell carcinoma (SCC) usually entails the uterine corpus by means of deep myometrial penetration or lymphatic dissemination, however superficial extension from the cervix into the uterine corpus is rare and stays poorly understood. This uncommon sample can create diagnostic challenges, notably as a result of involvement of the myometrium and adnexa is just not particularly integrated into the FIGO 2018 cervical most cancers staging system. On this report, the researchers describe how magnetic resonance imaging (MRI), histopathology, and immunohistochemistry helped characterize an uncommon case of cervical SCC extending superficially into the uterus and left fallopian tube.

The case concerned a 54-year-old postmenopausal girl who offered with postmenopausal bleeding and decrease belly ache lasting three months. A Pap smear and subsequent cervical biopsy revealed squamous cell carcinoma. Scientific evaluation initially labeled the illness as FIGO 2018 stage IA. MRI, nevertheless, revealed an irregular endometrial cavity and a 2.3 × 0.8 cm T2 hyperintense lesion involving the posterior lip of the cervix, with mural unfold alongside the uterine myometrium. Diffusion-weighted imaging (DWI) and obvious diffusion coefficient (ADC) mapping additionally demonstrated restricted diffusion within the lesion. Primarily based on these imaging findings, the provisional analysis was revised to superficially spreading cervical SCC involving the uterine endomyometrium, and the tumor was upstaged to FIGO stage IB3.

The affected person subsequently underwent radical hysterectomy. Histopathological examination confirmed pT1b3 cervical SCC with superficial unfold into the endometrium and myometrium, with myometrial invasion of lower than 50%. A 0.5 cm nodule on the fimbrial finish of the left fallopian tube additionally contained SCC. Immunohistochemistry confirmed p16 and p63 positivity and detrimental estrogen receptor (ER) and progesterone receptor (PR) staining within the tumor. Along with the continuity of the lesions, these findings supported secondary endometrial involvement originating from the cervical most cancers relatively than a separate main endometrial malignancy.

MRI was notably necessary as a result of superficial spreading cervical SCC could not current as an apparent cervical mass. The authors clarify that MRI offers detailed soft-tissue visualization, whereas DWI and ADC mapping can enhance distinction between tumor and surrounding tissue. On this affected person, the imaging sample advised extension into the uterine physique earlier than surgical procedure, and subsequent histopathology confirmed the unfold.

The literature overview recognized a number of beforehand reported MRI patterns related to superficially spreading cervical SCC. These included focal or irregular endometrial thickening, fluid accumulation throughout the uterine cavity, lack of the traditional junctional zone, intramural nodules, and restricted diffusion. As a result of an apparent cervical development was not current in all reported instances, the authors emphasize the potential worth of recognizing these much less typical imaging options when evaluating suspected cervical malignancy.

Pathological examination offers one other important layer of proof. The authors talk about two proposed mechanisms for this uncommon sample: horizontal unfold, wherein cervical neoplastic cells prolong alongside and exchange the endometrial epithelium, and a vertical or “discipline” mechanism wherein malignant lesions might come up independently beneath a shared carcinogenic affect. In most reported instances, nevertheless, the proof favors direct extension of cervical most cancers. Histological continuity between cervical, endometrial, and fallopian tube lesions will help help this interpretation.

“On this case, the presence of contiguous unfold from the cervix to the endometrium, as seen on MRI, and the histopathological findings supported a analysis of secondary endometrial involvement by cervical SCC.”

Following surgical procedure, a multidisciplinary oncology group determined towards further chemoradiation. At 18 months after surgical procedure, the affected person remained clinically nicely with no proof of illness recurrence. The authors observe, nevertheless, that remedy choices for this uncommon sample of cervical most cancers require cautious particular person evaluation and that potential research are wanted to higher set up optimum administration.

Total, this case highlights how MRI, notably when mixed with DWI and ADC mapping, will help determine uncommon superficial extension of cervical SCC which may be tough to understand by means of scientific examination alone. Histopathology and immunohistochemistry stay necessary for supporting tumor origin and distinguishing secondary endometrial involvement from a main endometrial malignancy. As a result of the findings are primarily based on a single affected person and a overview of a restricted variety of beforehand reported instances, they shouldn’t be interpreted as establishing a common diagnostic or remedy strategy. As an alternative, the report underscores the significance of integrating imaging, pathology, and multidisciplinary scientific evaluation when cervical most cancers shows an atypical sample of unfold.

DOI: https://doi.org/10.18632/oncoscience.668               

Correspondence to: Aparna Jarathi – aparna.obg@aiimsbibinagar.edu.in          

Key phrases: most cancers, postmenopausal bleeding, MRI, p16, p63, ER, PR

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