Peran Magnetic Resonance Imaging pada Diagnosis Kanker Serviks  yang Menyerupai Kanker Endometrium – Laporan Kasus

Febia Erfiandi; Ali Budi Harsono; Hari Soekersi; Birgitta Maria Dewayani; Jessica Kireina

doi:10.24198/obgynia.v7i1.444

Peran Magnetic Resonance Imaging pada Diagnosis Kanker Serviks yang Menyerupai Kanker Endometrium – Laporan Kasus

Febia Erfiandi, Ali Budi Harsono, Hari Soekersi, Birgitta Maria Dewayani, Jessica Kireina

Abstract

Pendahuluan: Magnetic resonance imaging (MRI) merupakan modalitas penting dalam diagnosis kanker ginekologi, terutama serviks dan endometrium. Laporan kasus ini bertujuan melihat peranan MRI dalam menentukan asal tumor, keterlibatan parametrium, dan metastasis kelenjar getah bening retroperitoneal.
Presentasi Kasus: Pada laporan kasus ini pasien didiagnosis kanker serviks stadium IB3 dengan diagnosis banding kanker endometrium stadium II karena keluhan perdarahan pasca-menopause, massa di serviks bersifat endofitik, dan ukuran uterus membesar. Hasil histopatologi kuretase yaitu endometrioid endometrial carcinoma moderately differentiated Dd/adenocarcinoma cervix. Magnetic resonance imaging (MRI) dilakukan untuk melihat asal tumor dan menetukan stadium. Skor MRI menganalisis tujuh perbedaan fitur: lokasi dan perfusi tumor, penyengatan perifer, massa atau distensi rongga endometrium, invasi miometrium, dan infiltrasi jaringan sekitar; skor 10 didapatkan pada kasus dengan menggunakan sekuens T2WI sagital, DWI-ADC, dan DCE yang menyimpulkan bahwa tumor berasal dari serviks dan telah menginfiltrasi parametrium.
Kesimpulan: Skor MRI bisa dijadikan pertimbangan untuk melihat asal tumor (serviks atau endometrium) selain melihat keterlibatan parametrium dan kelenjar getah bening pelvis sehingga diagnosis dan manajemen lebih baik.

The Role of Magnetic Resonance Imaging in the Diagnosis of Cervical Cancer Resembling Endometrial Cancer – A Case Report

Abstract
Objective: Magnetic resonance imaging (MRI) is an important modality in the diagnosis of gynecological cancer, especially cervical and endometrial cancer. This case report aims to examine the role of MRI in determining tumor origin, parametrial involvement, and retroperitoneal lymph node metastases.
Case presentation: In this case report, the patient was diagnosed with stage IB3 cervical cancer Dd/ stage II endometrial cancer due to complaints of postmenopausal bleeding, endophytic cervical mass, and uterine enlargement. The histopathological results of curettage were moderately differentiated endometrioid endometrial carcinoma Dd/adenocarcinoma of the cervix. Magnetic resonance imaging (MRI) is performed to determine the origin of the tumor and its stage. MRI score was analyzed for seven distinct features: tumor location and perfusion, peripheral rim, endometrial cavity mass or distension, invasion of the myometrium, and surrounding organs infiltration; score of 10 was obtained in these cases using sagittal T2WI, DWI-ADC, and DCE sequence which concluded that the tumor was cervical origin and had infiltrated the parametrium.
Conclusion: MRI score can be considered to see the origin of the tumor (cervical or endometrial) in addition look for involvement of the parametrium and pelvic lymph nodes so that diagnosis and management will be better.

Key words: Magnetic Resonance Imaging, Cervical Cancer, Endometrial Cancer, Gynecological Cancer, Parametrial Infiltration

Keywords

Magnetic Resonance Imaging, Kanker Serviks, Kanker Endometrium, Kanker Ginekologi, Infiltrasi Parametrium

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References

Bourgioti C, Chatoupis K, Panourgias E, Tzavara C, Sarris K, Rodolakis A, et al. Endometrial vs. cervical cancer: development and pilot testing of a magnetic resonance imaging (MRI) scoring system for predicting tumor origin of uterine carcinomas of indeterminate histology. Abdom Imaging. 2015 Oct 21;40(7):2529–40.

Rauch GM, Kaur H, Choi H, Ernst RD, Klopp AH, Boonsirikamchai P, et al. Optimization of MR Imaging for Pretreatment Evaluation of Endometrial and Cervical Cancer The use of thin section high resolution (HR) multi-planar T2 weighted images with simple NIH Public Access. Radiographics. 2014;34(4):1082–98.

Sone K, Eguchi S, Asada K, Inoue F, Miyamoto Y, Tanikawa M, et al. Usefulness of biopsy by office hysteroscopy for endometrial cancer: A case report. Mol Clin Oncol [Internet]. 2020 May 27;13(2):141–5. Available from: http://www.spandidos-publications.com/10.3892/mco.2020.2053.

Otero-García MM, Mesa-Álvarez A, Nikolic O, Blanco-Lobato P, Basta-Nikolic M, de Llano-Ortega RM, et al. Role of MRI in staging and follow-up of endometrial and cervical cancer: pitfalls and mimickers. Insights Imaging. 2019 Dec 13;10(1):19.

Patel-Lippmann K, Robbins JB, Barroilhet L, Anderson B, Sadowski EA, Boyum J. MR Imaging of Cervical Cancer. Magn Reson Imaging Clin N Am. 2017 Aug;25(3):635–49.

Nougaret S, Lakhman Y, Vargas HA, Colombo PE, Fujii S, Reinhold C, et al. From Staging to Prognostication: Achievements and Challenges of MR Imaging in the Assessment of Endometrial Cancer. Magn Reson Imaging Clin N Am. 2017 Aug;25(3):611–33.

Nougaret S, Horta M, Sala E, Lakhman Y, Thomassin-Naggara I, Kido A, et al. Endometrial Cancer MRI staging: Updated Guidelines of the European Society of Urogenital Radiology. Eur Radiol. 2019 Feb 11;29(2):792–805.

Meissnitzer M, Forstner R. MRI of endometrium cancer - How we do it. Cancer Imaging. BioMed Central Ltd.; 2016 May 9;16(1):1–9.

Mahajan A, Sable NP, Popat PB, Bhargava P, Gangadhar K, Thakur MH, et al. Magnetic Resonance Imaging of Gynecological Malignancies: Role in Personalized Management. Semin Ultrasound CT MR. Semin Ultrasound CT MR; 2017 Jun 1;38(3):231–68.

Chung HH, Kang KW, Cho JY, Kim JW, Park N-H, Song Y-S, et al. Role of magnetic resonance imaging and positron emission tomography/computed tomography in preoperative lymph node detection of uterine cervical cancer. Am J Obstet Gynecol. 2010 Aug;203(2):156.e1-156.e5.

DOI: http://dx.doi.org/10.24198/obgynia.v7i1.444