Fig. 25
From: Role of MRI in staging and follow-up of endometrial and cervical cancer: pitfalls and mimickers
a, b MRI of a 48-year-old woman with known adenomyosis, a previous cesarean section, and FIGO IA1 cervical cancer diagnosed in an outpatient clinic, including sagittal T2WI (a) and axial oblique T2WI (b). No anomalies are visible in the cervix. The cystic image in the right obturator space (arrow in b) was interpreted as a right ovary with a small follicle. The patient underwent simple extrafascial hysterectomy with ovarian removal. Post-surgical histology confirmed FIGO stage IA1 (high-grade squamous cell carcinoma), without LVSI and with a clear surgical margin. c, d MRI was performed 6 months after surgery, including axial oblique T2WI (c) and coronal MIP-DCE sequence imaging (d). The right obturator cystic lesion increased in size and in contact with right iliac vessels (arrows). Images also show medial displacement of the right pelvic peritoneal fascia (red arrowhead) indicating an extraperitoneal origin of the cystic lesion. e 18F-FDG PET-CT shows avid enhancement of the cystic mass. Lymphadenectomy was performed. Histological analysis showed metastatic adenopathy of cervical cancer