0:01

This case is a companion case to the

0:03

endometrial cancer case that I showed

0:05

via ultrasound, except this patient is a

0:07

29-year-old who presented with bleeding.

0:10

And here we're focused again on the

0:11

lower uterine segment cervix area.

0:14

And you can see this very heterogeneous lesion.

0:17

This one may have some calcifications within it.

0:20

Like on this ultrasound, you can sort of see

0:21

the splaying of the cervical tissue a bit more

0:24

than you could see on the last case right here.

0:26

It's the other side of the cervix right here.

0:31

So it's very similar to our last

0:33

case of endometrial carcinoma.

0:35

If you go to color Doppler, you can see again,

0:39

this structure is not just blood product,

0:41

which would also account for her vaginal

0:43

bleeding, but it's a very hypervascular mass.

0:45

So we talked earlier on the last

0:47

case, when you see something like this

0:49

centered in the cervix or lower uterine

0:50

segment, you're thinking cervical cancer,

0:52

you're thinking endometrial cancer.

0:54

We'll go here to our transabdominal view,

0:56

as you can see up here, to see the rest of the

0:58

uterus because we couldn't see it transvaginally

1:00

because the uterus was so enlarged.

1:02

You can see endometrium right here.

1:04

You can see a bit of the fundus

1:05

up here in the uterine body.

1:08

That mass is going to be somewhere down here.

1:09

We don't see well, but what's important

1:11

is the endometrium up here is normal.

1:16

Given this patient's age, however,

1:18

endometrial cancer is going to be a lot

1:20

less likely than a cervical cancer is.

1:22

So we saw this, we recommended an MRI.

1:25

I'm just going to show you

1:26

the T2 sagittal image here.

1:28

And you can see it, this is very

1:29

clearly a cancer arising in the

1:32

cervix, lower uterine segment area.

1:34

You need a biopsy for this, and she did end up

1:35

coming back with a cervical cancer, primary.

1:39

And has some areas of extension

1:41

to the bladder and to the rectum.

1:43

So these cancers, the endometrial cancer case

1:46

and this cervical cancer case look very, very

1:48

similar to my eye, especially on ultrasound.

1:51

So it really is going to be a differential

1:52

when you see something in the cervical

1:55

lower uterine segment area. You can use

1:57

age of the patient to help guide you,

1:59

but ultimately you're still going to

2:00

need that biopsy to diagnose the patient.