Recurrent Cervical Cancer: How Can Radiology be Helpfull

Abstract

Uterine cervical carcinoma is one of the most common malignancies occurring in females and although the longer survival provided by the advances in early diagnosis and effective treatment, 30% of the patients develop persistent or recurrent disease. Recurrent disease is defined by local tumor re-growth or development of nodal or distant metastases at least 6 months after the lesion has regressed. Recurrent disease can occur centrally in the uterus or vaginal vault, laterally in the pelvic wall, can present as pelvic and extra-pelvic lymph node disease and as distant metastases. Although CT can be useful for surveillance MR is the most accurate imaging tool for characterization of pelvic recurrence. MR findings depend on previous therapeutics so the knowledge of imaging features of surgery and of the irradiated pelvis are crucial. Dynamic contrast-enhanced subtraction MR and diffusion weighted images give a valuable contribute in differential diagnosis of pelvic recurrence and inflammatory effects of radiation therapy but biopsy and serial imaging may be warranted. The authors review the spectrum of imaging findings of recurrent cervical carcinoma.