Objective:To investigate the clinical and imaging characteristics of Gastric-type En-docervical Adenocarcinoma(G-EAC)with a view to increasing the level of awareness and early diagno-sis.Methods:In this study,we retrospectively and consecutively collected and analyzed clinical and ima-ging data from eight patients with pathologically confirmed G-EAC.The data was collected at our hos-pital between October 2018 to May 2023.Out of the eight patients,four received preoperative MRI,six received gynecological ultrasound,and two underwent CT examinations.Additionally,six patients un-derwent colposcopy and cervical routine biopsy.Results:①Clinical characteristics:among the 8 cases analyzed,3 presented with vaginal discharge,including 1 case of profuse discharge,2 cases with vaginal bleeding,and 3 cases with suspected cervical lesions identified through routine gynecological ultra-sound.Cervical liquid-based cytology(TCT)was negative in 5 cases(5/8),while human papilloma-virus(HPV)testing was negative in 7 cases(7/8).Six patients underwent colposcopy and cervical routine biopsy,of whom 4 cases(4/6,4/6)were negative.②Imaging manifestations:in the 4 cases that underwent MRI,all presented with an enlarged cervix in the shape of a"barrel,"uneven parenchy-mal signal with slightly longer T1 and T2 signals,and multiple rounded long T1 and long T2 signal shadows of varying sizes visible in the cervix presenting the"cosmic sign."Only one patient had cervi-cal gastric adenocarcinoma that was considered for a correct MRI diagnosis(1/4).In 2 cases,CT ex-amination showed an enlarged cervix with"barrel-shaped cervix,"uneven density,scattered multiple nodules,and small flaky low-density shadows.In one case,enhancement examination revealed a cystic area with no enhancement,and the solid part had uneven enhancement with a poorly defined border.Ultrasound examination in 6 cases revealed an enlarged cervix with heterogeneous echoic masses,hon-eycomb-like appearance,and rich blood flow signals inside and around the masses.Only 1 case(1/8)was correctly diagnosed as G-EAC by preoperative imaging,leading to a misdiagnosis/missing diagno-sis rate of 87.5％.Conclusion:Cervicogastric adenocarcinoma presents with specific clinical features and imaging characteristics.The persistent presence of a large amount of vaginal fluid with a"barrel-shaped cervix"and presenting the"cosmic sign"can aid in early diagnosis.MRI also holds diagnostic value in identifying the condition.
维普
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