Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2024; 12(24): 5583-5588
Published online Aug 26, 2024. doi: 10.12998/wjcc.v12.i24.5583
Endometrial carcinoma with cervical stromal invasion: Three case reports
Ming-Ming Liu, Yu-Ting Liang, Er-Hu Jin
Ming-Ming Liu, Er-Hu Jin, Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Ming-Ming Liu, Yu-Ting Liang, Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100006, China
Co-corresponding authors: Yu-Ting Liang and Er-Hu Jin.
Author contributions: Liu MM contributed to manuscript writing and editing, and data collection; Liang YT and Jin EH contributed to conceptualization and supervision; all authors have read and approved the final manuscript. Both Jin EH and Liang YT have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Jin EH conceptualized, designed, and supervised the whole process of the project. He searched the literature, revised and submitted the early version of the manuscript. Liang YT was instrumental and responsible for data re-analysis and re-interpretation, comprehensive literature search, preparation and submission of the current version of the manuscript. This collaboration between Jin EH and Liang YT is crucial for the publication of this manuscript and other manuscripts still in preparation. Jin EH takes primary responsibility for communication with the journal during the manuscript submission, peer review, and publication processes.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Er-Hu Jin, MD, Doctor, Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China. erhujin@ccmu.edu.cn
Received: December 26, 2023
Revised: June 4, 2024
Accepted: June 24, 2024
Published online: August 26, 2024
Processing time: 197 Days and 21.3 Hours
Abstract
BACKGROUND

Endometrial cancer is a kind of well-known tumors of female genitourinary system. Cervical stromal invasion is an adverse factor for poor prognosis of endometrial cancer. There is still controversy regarding the use of magnetic resonance imaging (MRI) in the diagnosis of cervical stromal invasion of endometrial cancer. The diagnosis of cervical stromal invasion varies significantly between different observers and institutions. We present a limited case series of the particular pattern of endometrial cancer, which infiltrates the cervical stroma and is often overlooked.

CASE SUMMARY

We present three cases of endometrial carcinoma with cervical stromal invasion with cancer-free uterine cavity. One patient, a reproductive-aged woman, exhibited irregular menstruation and was diagnosed with endometrial polyps by hysteroscopy and segmental curettage. A MRI scan revealed polypoid nodules within the internal cervical orifice. The other two cases were postmenopausal women who presented with abnormal vaginal bleeding. Hysteroscopy and segmental curettage suggested atypical hyperplasia of the endometrium. MRI scans did not detect any malignant signs in the endometrium. In one case, a non-thickened endometrium was observed, while in another, hyperplasia of the endometrium was seen. Notably, none of these patients had malignant tumors identified in the uterine cavity via MRI scans. However, postoperative pathological results following hysterectomy consistently indicated cervical stromal invasion.

CONCLUSION

Cervical stromal invasion is easily missed if no cancer is found in the uterine body on MRI. Immunohistochemistry of endoscopic curettage specimens should be conducted to avoid underestimation of the disease.

Keywords: Endometrial carcinoma, Cervical stromal invasion, Atypical hyperplasia of the endometrium, Magnetic resonance imaging, Case report

Core Tip: We focus on endometrial carcinoma with cervical stromal invasion, given its correlation with reduced 5-year survival rates and heightened lymph node metastasis risk in patients diagnosed with endometrial cancer. Patients with cervical stromal invasion are required to have a total hysterectomy and lymphadenectomy. In contrast, they only require a total hysterectomy. In instances of endometrial carcinoma that involves the cervix but lacks an apparent primary uterine body tumor, magnetic resonance imaging examinations should be performed with greater caution to prevent potential misdiagnoses.