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60-year-old female had routine Pap suspicious for adenocarcinoma. Bimanual exam shows firm cervical os, no symptoms reported.
MRI showed thickening and heterogenous signal in endometrium c/w known endometrial Ca. Appears to be FIGO Stage 2 disease w/involvement of cervical glands. No extension through myometrium into surrounding structures.
Endometrium biopsy: Grade 2 moderately differentiated endometrioid adenocarcinoma.
Uterus: superficially invasive endometrioid adenocarcinoma, moderately differentiated, measuring 3 cm, involves endocervical glands. All margins negative. Bilateral tubes and ovaries negative. Left iliac lymph nodes 0/3 positive. Para-aortic lymph nodes 0/4 positive.
Surgery: Total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy.
Radiation: 2100 cGy in three fractions to vaginal cuff using Iridium-192 HDR brachytherapy