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ECR 2018 / C-3205
Uterine mass in pelvic MRI : the "atypical" myoma puzzle for the radiologist and the gynecologist.
Congress: ECR 2018
Poster No.: C-3205
Type: Educational Exhibit
Keywords: Pelvis, Oncology, MR, MR-Diffusion/Perfusion, MR-Functional imaging, Education, Diagnostic procedure, eLearning, Pathology, Cancer
Authors: G. Levy1, S. Taieb2; 1Nice/FR, 2Lille/FR
DOI:10.1594/ecr2018/C-3205

Conclusion

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 pre-therapeutic management, associating T2-weighted images correlated with DWI (b1000 hyperintensity with restricted ADC) and perfusion : MRI diagnostic accuracy > 90%. Table 6

 

Surgical consequences : fertility in young woman in case of radical hysterectomy for leiomyoma and overall survival in case of "failed" sarcoma with tumoral morcellation.

 

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