Ultrasound imaging of the pelvis revealed:
There was an anechoic collection (fluid) in the endometrial cavity, with particulate matter. A provisional diagnosis of pyometra was made.
Among the diagnostic possibilities in such a case, are carcinoma cervix and cervical stenosis.
Looking to the age of patient, a detailed enquiry was done, and she gave a history of earlier diagnosis of carcinoma cervix.
Final diagnosis: carcinoma cervix with large pyometra.
1. Thickened endometrium: The endometrium, or the inner lining of the uterus, may appear thicker than normal on ultrasound due to the presence of pyometra.
2. Fluid in the uterine cavity: Pus or other fluid may be seen inside the uterus on ultrasound, which is indicative of pyometra.
3. Enlarged uterus: The uterus may be enlarged due to the accumulation of pus or the presence of a cervical mass or lesion.
4. Cervical mass or lesion: A mass or lesion in the cervix may be seen on ultrasound, which may indicate the presence of cervical cancer.
5. Abnormal lymph nodes: Enlarged or abnormal lymph nodes in the pelvis may be seen on ultrasound, which may indicate the spread of cervical cancer.
6. Ascites: The presence of fluid in the abdominal cavity, known as ascites, may be observed on ultrasound in advanced cases of cervical cancer.
7. Invasive growth: If cervical cancer has spread beyond the cervix, ultrasound may show invasion of nearby organs, such as the bladder or rectum.
It is important to note that while ultrasound can provide valuable information in the diagnosis and management of cervical cancer and pyometra, a definitive diagnosis usually requires further testing such as a biopsy.
Patient did not permit transvaginal ultrasound during the current study.
The following are possible approaches to management and the potential prognosis for each stage:
1. Stage 0: For early-stage cervical cancer, such as carcinoma in situ, the recommended treatment is a cone biopsy or a loop electrosurgical excision procedure (LEEP). The prognosis for stage 0 cervical cancer is generally good, with a 5-year survival rate of over 90%.
2. Stage I: In this stage, the cancer is confined to the cervix. Treatment options may include surgery, radiation therapy, or a combination of both. The prognosis for stage I cervical cancer is generally favorable, with a 5-year survival rate of around 80-90%.
3. Stage II: The cancer has spread beyond the cervix but has not yet reached the pelvic wall or lower part of the vagina. Treatment may involve surgery, radiation therapy, chemotherapy, or a combination of these. The prognosis for stage II cervical cancer depends on the extent of the spread, but the 5-year survival rate is generally between 60-80%.
4. Stage III: The cancer has spread to the lower part of the vagina or the pelvic wall. Treatment usually involves a combination of surgery, radiation therapy, and chemotherapy. The prognosis for stage III cervical cancer is less favorable, with a 5-year survival rate of around 30-40%.
5. Stage IV: The cancer has spread to distant organs, such as the bladder or rectum. Treatment may involve radiation therapy, chemotherapy, or palliative care to manage symptoms. The prognosis for stage IV cervical cancer is poor, with a 5-year survival rate of around 15-20%.
In cases of pyometra, treatment involves draining the pus from the uterus and treating any underlying infection. This may involve antibiotics, a catheter, or surgery.
Overall, the prognosis for cervical cancer depends on the stage and extent of the cancer, as well as the individual's overall health and response to treatment. Early detection and treatment can improve the chances of a favorable outcome.
(Images in this case are courtesy of Dr Sheriff).
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