Characteristics of the magnetic resonance imaging findings of cervical gastric-type adenocarcinoma

• Published in: Clinical radiology 2024-10, Vol.79 (10), p.e1189-e1195
• Main Authors: Kikkawa, N., Sugawara, H., Yoshida, H., Kobayashi-Kato, M., Tanase, Y., Uno, M., Ishikawa, M., Kato, T., Kusumoto, M.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Adult; Aged; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Cervix Uteri - diagnostic imaging; Cervix Uteri - pathology; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging - methods; Middle Aged; Retrospective Studies; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - pathology; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - pathology
• ISSN: 0009-9260; 1365-229X; 1365-229X
• DOI: 10.1016/j.crad.2024.04.016

This study identified the distinct magnetic resonance imaging findings of cervical gastric–type adenocarcinoma (GAS) that can help differentiate it from squamous cell carcinoma (SCC) and usual-type endocervical adenocarcinoma (UEA) and reveal the radiologic–pathologic correlation. All consecutive patients with cervical GAS treated at our hospital from November 2009 to August 2021 were included. The SCC and UEA cases were considered controls. Tumor location, tumor shape, presence and size of cysts, presence of uterine fluid, and apparent diffusion coefficient (ADC) were evaluated. Overall, 18 GAS, 55 SCC, and 23 UEA cases were evaluated. The tumor was located in the entire cervix in 13/18 GAS cases, whereas it was predominantly located in the lower cervix in 38/55 SCC cases and 14/23 UEA cases. Most GAS cases exhibited a diffuse infiltration growth pattern (17/18), whereas most SCC and UEA cases exhibited a mass-forming pattern (39/55 and 20/23, respectively). Moreover, the percentages of cases presenting microcysts or macrocysts and undergoing uterine fluid collection were significantly higher in the GAS group (14/18 and 13/18) than in the SCC and UEA groups. ADC was significantly higher in the GAS group than in the SCC group (1.092 × 10−3 vs. 0.819 × 10−3 mm2/s). This study revealed that GAS is characterized by tumor presence in the entire cervix, infiltrative growth pattern, intrauterine fluid collection, and frequent microcyst or macrocyst formation. Moreover, ADC was significantly higher in the GAS group than in the SCC group. •Image characteristics of cervical gastric-type adenocarcinoma•Lesion involvement of the entire cervix.•Diffuse growth pattern.•Intrauterine fluid collection.•Frequent cyst formation.•High ADC values compared to SCC.