Article Text

Download PDFPDF

2022-RA-594-ESGO Application of ultrasound in cervical cancer (a case report and updated literature review)
  1. Dusan Djokovic1,2,3,
  2. Conceição Telhado2,
  3. José Silva Pereira2 and
  4. Pedro Conde2
  1. 1Gynecology and Obstetrics (MAC), CHULC, Lisboa, Portugal
  2. 2Hospital CUF Descobertas, Lisbon, Portugal
  3. 3NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal


Introduction/Background Technological development and specialized training of operators have led to the increasing usefulness of ultrasonography (US) in patients with cervical cancer (CC). Most women with squamous cell CC (SCC) present hypoechoic lesions and increased vascularity, while rare-type CC are commonly isoechoic. This communication presents a case of SCC with less frequent US characteristics and summarizes updated information on the role of US in CC.

Methodology Case report and non-systematic literature review (MEDLINE, 2012 – 2022).

Results A 38-year-old nulliparous woman, with an irrelevant medical history, no desire to procreate, never involved in the immunization and CC screening programs by personal decision, was admitted to our department due to intense acute genital hemorrhage. Physical examination revealed a bleeding nodular lesion, apparently protruding from the cervical canal. Bleeding was controlled by tamponade. Transrectal US indicated an anterior cervical isoechoic lesion (34 x 21 x 30 mm), with an ovoid shape, regular edges and lateral acoustic shadows (see accompanying images). Although these were not the most common US characteristics of CC, the Doppler study (color score 3) raised suspicion. No signs of parametrial affectation were observed. Colposcopy with biopsy was performed (histological diagnosis: non-keratinizing SCC). Pretreatment gynecological US and magnetic resonance imaging (MRI) provided concordant information while thoraco-abdominal computerized tomography did not evidence secondary lesions (T1b1N0M0). The patient underwent radical hysterectomy (type C), bilateral salpingectomy, bilateral pelvic lymph node dissection and ovarian transposition. In accordance with the literature: transvaginal/transrectal expert US provides highly accurate information on detecting CC, being a convenient and cost-effective modality for assessing local extension (accuracy similar to that of MRI). Doppler studies may be useful for evaluating responses to various treatments. US guidance may be helpful in the delivery of intracavitary brachytherapy.

Abstract 2022-RA-594-ESGO Figure 1

Conclusion Expert US provides valuable information for detecting invasive CC and assessing the local tumor spread.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.