# Superficial Spreading Cervical Squamous Cell Carcinoma Manifesting as Intrauterine Mural Nodules on Magnetic Resonance Imaging

## TL;DR

A rare case of cervical cancer spreading into the uterus was identified using MRI, showing how the disease can appear as nodules in imaging.

## Contribution

This case highlights the MRI features of superficially spreading cervical SCC, aiding in its early recognition.

## Key findings

- MRI showed intrauterine mural nodules with restricted diffusion in a patient with cervical SCC.
- DWI imaging was effective in identifying the tumor's spread into the uterine lumen.
- Histopathology confirmed the superficial extension of cervical SCC into the uterus.

## Abstract

Superficially spreading cervical squamous cell carcinoma (SCC) is the superficial extension of SCC of the cervix into the uterine lumen, replacing the endometrium. Here, we report a case of superficially spreading cervical SCC manifesting as intrauterine mural nodules with restricted diffusion on magnetic resonance imaging (MRI). A 76-year-old woman with a history of conization presented with a pelvic mass. MRI revealed a large cystic lesion with mural nodules and wall thickening. The nodular lesions and thickened walls showed high signal intensity on diffusion-weighted imaging (DWI) and low signal intensity on apparent diffusion coefficient (ADC) maps. We performed a laparotomy for diagnosis and treatment and suspected that the tumor was of uterine origin. Hysterectomy and bilateral adnexectomy were performed. Histopathological examination revealed superficial spreading of the cervical SCC. Superficially spreading cervical SCC can manifest as intrauterine mural nodules on MRI. DWI is useful for delineating this disease. If mural nodules or endometrial thickening with restricted diffusion are found in the uterine lumen, clinicians should consider the possibility of the superficial spread of cervical SCC.