PMC10257776_01
Coronal and CT images of 18F-FDG PET/CT scans at three different time points: initial diagnosis (A and B), at the time of local recurrence (C and D) showing an intense hypermetabolic right pelvic lymph node mass, and after two cycles of CHT (E and F) showing a partial metabolic response (DeltaSUVmax -65%), but with an increase in volume of the right pelvic mass on CT images probably due to necrotic tissue (red arrow on D and F images). 18F-FDG: 18Fluorine-fluorodeoxyglucose; CHT: Chemotherapy; CT: Computed tomography; PET: Positron emission tomography; SUVmax: Maximum standardized uptake value.
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PMC10257776_01_RJME-64-1-83-fig1.jpg
F1
Positron emission tomography/computed tomography (PET/CT) did not show significant 18Fluorine-fluorodeoxyglucose (18F-FDG) uptake in the uterine cervix and no other foci of 18F-FDG avidity in the rest of the whole-body scan (Figure 1A and 1B). The mass had intense metabolic activity [maximum standardized uptake value (SUVmax) 11.3] on 18F-FDG PET/CT scan (Figure 1C and 1D) without any evidence of metastatic disease. DeltaSUVmax -65%) but with an increase in size (6 cm) on CT scan images (Figure 1E and 1F). Due to the discrepancy between the two imaging techniques, it was decided to complete the CHT (for five cycles in total, then stopped for toxicity) and to do an external RT (50 Gy) before surgical resection.
Macroscopic (A and B) and microscopic (C-E) views of the polypoid uterine cervical mass. Hematoxylin-Eosin staining (C) showing the fusiform cells with oval nuclei in a myxoid stroma associated with a densification of these stromal cells (cambium layer) beneath the surface, highlighted better after immunohistochemistry (D and E). The tumor had nuclear myogenin immunostaining (D) and diffuse cytoplasmic desmin immunostaining (E). Scale bar: (C) 250 mum; (D) 50 mum; (E) 100 mum.
RJME-64-1-83-fig2.jpg
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F2
This lesion prolapsed from the cervix ostium (Figure 2A and 2B). The surface was delimited by a squamous epithelium above a densification of stromal cells (cambium layer) beneath the surface (Figure 2C). The immunohistochemistry (IHC) was positive for myogenin (Ventana BenchMark ULTRA, Sanbio, anti-mouse antibody MYF4, clone F5D, 1/1 dilution) and desmin (Ventana BenchMark ULTRA, Agilent, anti-mouse antibody, clone D33, 1/1 dilution) (Figure 2D and 2E).