PMC5960523_01
Transvaginal ultrasound examination of pelvic organs. (a) Sagittal view of the uterus with thick mildly heterogeneous endometrium measuring 1.6 cm, without discrete polyp or mass lesion. (b) Possible hypervascular stalk on color Doppler evaluation suggestive of possible endometrial mass.
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Pelvic anatomy was evaluated with transvaginal sonography, which revealed a thickened, 1.6 cm mildly heterogeneous and hypervascular endometrium without identification of a discrete mass but with a possible hypervascular stalk suggestive of polyp (Figure 1).
Magnetic resonance imaging of pelvic organs with Gadavist intravenous contrast demonstrated a 3.5 x 1.2 x 1.5 cm T2 enhancing mass with less than 50% invasion into the myometrium. No evidence of local regional metastatic disease.
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Pelvic and abdominal MRI were performed and revealed less than 50% invasion into the myometrium and no apparent extra uterine disease (Figure 2).
Endometrial adenocarcinoma, endometrioid type with squamous differentiation. (a) Sharp demarcation between adenocarcinoma and adjacent endometrium showing atypical complex hyperplasia. (b) Squamous metaplasia within endometrioid type adenocarcinoma. (c) Photomicrograph demonstrating endometrioid adenocarcinoma with prominent areas of squamous metaplasia (arrows).
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TNM staging was pT1aN0, FIGO stage IA (Figure 3). The patient is currently recovering well from the surgery.