Case 5

This is an MRI pelvis study - there is a large solid mass arising from the cervix, and showing relatively high T2 signal intensity compared to the normally hypointense cervical stroma. It also demonstrates low ADC values, indicating diffusion restriction.

It exhibits local extension beyond the cervical walls into the parametrial fat, and also extends to the upper third of the vagina. There is no extension to the rectum or bladder wall. I note an enlarged right internal iliac group lymph node.

The findings represent a malignant mass arising from the cervix with local invasion, with a metastatic deep pelvic lymph node. There are no suspicious bony lesions that I can see on this study.

This is a cervical carcinoma which corresponds to FIGO stage IIB.

I would recommend gynaecological referral if the patient is not already under OBGYN care. I would also flag this case for discussion at the relevant gynaecological oncology MDT; complete staging should be done to assess distant spread, either by CT chest abdomen and pelvis or FDG-PET scanning.