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Endometrial stromal sarcoma mimicking submucosal myoma protruding to the vagina: MRI findings

  • J.C.-W. Chien1
  • S.C. Hsieh1
  • R.C. Lee2
  • C.Y. Chen1,3
  • C.J. Cheng4
  • W.P. CHAN1,*,

1Department of Radiology, Taipei Medical University-Municipal Wan Fang Hospital, Taiwan

2Department of Radiology, Veterans General Hospital-Taipei, Taiwan

3Department of Radiology, School of Medicine, Taipei Medical University, Taiwan

4Department of Pathology, School of Medicine, Taipei Medical University, Taipei, Taiwan

DOI: 10.12892/ejgo200506657 Vol.26,Issue 6,November 2005 pp.657-660

Published: 10 November 2005

*Corresponding Author(s): W.P. CHAN E-mail:

PDF (3.75 MB)

Abstract

A 46-year-old woman complained of persistent abnormal vaginal bleeding over ten days. Her intrauterine device had been removed two years before. Soon after, she suffered from menorrhagia and metrorrhagia. An incidental finding of severe anemia was also noted. In this admission, our initial T2-weighted magnetic resonance imaging (MRI) revealed a well-demarcated mass predominantly in the uterine cavity. The mass was depicted by an isointense signal relative to the myometrium on T1-weighted images, high signal intensity on T2-weighted images, and slightly heterogeneous enhancement on post-contrast images. The patient refused surgery. After two years, follow-up MRI showed a pedunculated mass protruding into the upper third of the vagina with a stalk connecting to the posterior wall of the uterine cavity, simulating submucosal myoma. Histological diagnosis was compatible with low-grade endometrial stromal sarcoma.

Keywords

Endometrium; Magnetic resonance imaging (MRI); Sarcoma; Tumor; Uterus; Vagina

Cite and Share

J.C.-W. Chien,S.C. Hsieh,R.C. Lee,C.Y. Chen,C.J. Cheng,W.P. CHAN. Endometrial stromal sarcoma mimicking submucosal myoma protruding to the vagina: MRI findings. European Journal of Gynaecological Oncology. 2005. 26(6);657-660.

URL:

https://www.ejgo.net/articles/10.12892/ejgo200506657

References

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[2] Koyama T., Togashi K., Konishi I., Kobayashi H., Ueda H., Kataoka M.L. et al.: "MR imaging of endometrial stromal sarcoma: Correlation with pathologic findings". Am. J. Radiol., 1999, 173, 767.

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[4] Rha S.E., Byun J.Y., Jung S.E., Lee S.L., Cho S.M., Hwang S.S. et al.: "CT and MRI of uterine sarcomas and their mimickers". Am. J Roentgenol., 2003, 181, 1369.

[5] Sahdev A., Sohaib S.A., Jacobs I., Shepherd J.H., Oram D.H., Reznek R.H.: "MR imaging of uterine sarcomas". Am. J. Roentgenol., 2001, 177, 1307.

[6] Gandolfo N., Gandolfo N.G., Serafini G., Martinoli C.: "Endometrial stromal sarcoma of the uterus: MR and US findings". Eur. Radiol., 2000, 10, 776.

[7] Ueda M., Otsuka M., Hatakenaka M., Sakai S., Ono M., Yoshimitsu K. et al.: "MR imaging findings of uterine endometrial stromal sarcoma: differentiation from endometrial carcinoma". Eur. Radiol., 2001, 11, 28.

[8] Toprak U., Pasaoglu E., Karademir M.A., Gulbay M.: "Sonographic, CT and MRI findings of endometrial stromal sarcoma located in the myometrium and associated with peritoneal inclusion cyst". Am. J. Roentgenol., 2004, 182, 1531.

[9] Ueda M., Otsuka M., Hatakenaka M., Torii Y.: "Uterine endometrial stromal sarcoma located in uterine myometrium: MRI appearance". Eu,: Radiol., 2000, 10, 780.

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