To illustrate MRI diagnostic pitfalls with benign and malignant uterine masses,
and how radiologist's interpretation between two diagnoses (myoma or sarcoma) impacts surgical therapeutic decision.
Uterine leiomyomas are the most common gynecologic tumor (commonly diagnosed in pelvic ultrasound and affecting 50% of women at menopause),
whereas the incidence of uterine sarcomas is rare (1.7 per 100,000 women) with a majority of leiomyosarcomas (LMS) 1,2,3 . Myoma and LMS are at the opposite ends of pathologic spectrum of uterine smooth muscle tumors,
including «leiomyoma variants» such as mitotically active,
and atypical myomas; as well as smooth muscle tumor of uncertain...
Findings and procedure details
TABLE OF CONTENTS : Degenerative modifications in myomas are frequent and often associated (hyaline fibrosis or œdema > 50% of cases).
They modify the MRI signal of the myoma +/- heterogeneity on T2-weighted images 7,8 . Table 3 Table 4 In this work,
we revised the key imaging findings (morphological and functionnal MRI) with their histopathological correlation in : myomas and leiomyomas variants (cystic,œdematous,
A single uterine tumor discovered after 45 years must remind one of sarcoma,
without forgetting the frequent degenerative modifications in ordinary myoma that modify its MRI signal (specially T2). Frequency argument : 2 leiomyosarcomas per 1000 uterine myomas. Pelvic MRI in myomas is indicated for mapping of a large polymyomatous uterus / before myomectomy or if atypical myoma in ultrasound or increase in size in post menopause. Full pelvic MRI protocol is justified if "atypical" myoma in...
MD. email : firstname.lastname@example.org Image In - Women's Imaging Center. 14 Allée Lazare Sauvaigo,
98000 Monaco email@example.com Tel.
: 04 22 170 222 + 377 97 77 89 60 CHRU Nice,L'Archet 2 Hospital - Department of Radiology and Multidisciplinary PreNatal Diagnosis Center. 151 Route de Saint-Antoine,
06200 Nice Tel.
: 04 92 03 77 77
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Fertil Steril 1981; 36:433–445. Leibsohn S and al.
Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas.
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discussion 974-6. Kagan Arleo E and al.Review of Leiomyoma Variants,
AJR October 2015. Blaustein’s Pathology of the...