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Uterine Leiomyosarcoma
Christine O. Menias, MD; Oguz Akin, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Malignant smooth muscle tumor of uterus arising from myometrial tissue or smooth muscle of myometrial vessels

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Sato K et al: Clinical application of diffusion-weighted imaging for preoperative differentiation between uterine leiomyoma and leiomyosarcoma. Am J Obstet Gynecol. 210(4):368, 2014
                                            2. Tirumani SH et al: Current concepts in the imaging of uterine sarcoma. Abdom Imaging. 38(2):397-411, 2013
                                            3. Shah SH et al: Uterine sarcomas: then and now. AJR Am J Roentgenol. 199(1):213-23, 2012
                                            4. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                            5. Qiu LL et al: Sarcomas of abdominal organs: computed tomography and magnetic resonance imaging findings. Semin Ultrasound CT MR. 32(5):405-21, 2011
                                            6. Wu TI et al: Clinical presentation and diagnosis of uterine sarcoma, including imaging. Best Pract Res Clin Obstet Gynaecol. 25(6):681-9, 2011
                                            7. Cornfeld D et al: MRI appearance of mesenchymal tumors of the uterus. Eur J Radiol. 74(1):241-9, 2010
                                            8. Amant F et al: Clinical management of uterine sarcomas. Lancet Oncol. 10(12):1188-98, 2009
                                            9. Fukunishi H et al: Unsuspected uterine leiomyosarcoma: magnetic resonance imaging findings before and after focused ultrasound surgery. Int J Gynecol Cancer. 17(3):724-8, 2007
                                            10. Wu TI et al: Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecol Oncol. 100(1):166-72, 2006
                                            11. Acharya S et al: Rare uterine cancers. Lancet Oncol. 6(12):961-71, 2005
                                            12. Livi L et al: Treatment of uterine sarcoma at the Royal Marsden Hospital from 1974 to 1998. Clin Oncol (R Coll Radiol). 16(4):261-8, 2004
                                            13. Tanaka YO et al: Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings. J Magn Reson Imaging. 20(6):998-1007, 2004
                                            14. Cantisani V et al: Vaginal metastasis from uterine leiomyosarcoma. Magnetic resonance imaging features with pathological correlation. J Comput Assist Tomogr. 27(5):805-9, 2003
                                            15. Kido A et al: Diffusely enlarged uterus: evaluation with MR imaging. Radiographics. 23(6):1423-39, 2003
                                            16. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                            17. Szklaruk J et al: MR imaging of common and uncommon large pelvic masses. Radiographics. 23(2):403-24, 2003
                                            18. Goto A et al: Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer. 12(4):354-61, 2002
                                            19. Ohara N. Related Articles et al: A comparison of MRI findings of uterine leiomyosarcoma before surgery and at recurrence. J Obstet Gynaecol. 22(1):99, 2002
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Malignant smooth muscle tumor of uterus arising from myometrial tissue or smooth muscle of myometrial vessels

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Sato K et al: Clinical application of diffusion-weighted imaging for preoperative differentiation between uterine leiomyoma and leiomyosarcoma. Am J Obstet Gynecol. 210(4):368, 2014
                                                                                      2. Tirumani SH et al: Current concepts in the imaging of uterine sarcoma. Abdom Imaging. 38(2):397-411, 2013
                                                                                      3. Shah SH et al: Uterine sarcomas: then and now. AJR Am J Roentgenol. 199(1):213-23, 2012
                                                                                      4. Tropé CG et al: Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 51(6):694-705, 2012
                                                                                      5. Qiu LL et al: Sarcomas of abdominal organs: computed tomography and magnetic resonance imaging findings. Semin Ultrasound CT MR. 32(5):405-21, 2011
                                                                                      6. Wu TI et al: Clinical presentation and diagnosis of uterine sarcoma, including imaging. Best Pract Res Clin Obstet Gynaecol. 25(6):681-9, 2011
                                                                                      7. Cornfeld D et al: MRI appearance of mesenchymal tumors of the uterus. Eur J Radiol. 74(1):241-9, 2010
                                                                                      8. Amant F et al: Clinical management of uterine sarcomas. Lancet Oncol. 10(12):1188-98, 2009
                                                                                      9. Fukunishi H et al: Unsuspected uterine leiomyosarcoma: magnetic resonance imaging findings before and after focused ultrasound surgery. Int J Gynecol Cancer. 17(3):724-8, 2007
                                                                                      10. Wu TI et al: Prognostic factors and impact of adjuvant chemotherapy for uterine leiomyosarcoma. Gynecol Oncol. 100(1):166-72, 2006
                                                                                      11. Acharya S et al: Rare uterine cancers. Lancet Oncol. 6(12):961-71, 2005
                                                                                      12. Livi L et al: Treatment of uterine sarcoma at the Royal Marsden Hospital from 1974 to 1998. Clin Oncol (R Coll Radiol). 16(4):261-8, 2004
                                                                                      13. Tanaka YO et al: Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings. J Magn Reson Imaging. 20(6):998-1007, 2004
                                                                                      14. Cantisani V et al: Vaginal metastasis from uterine leiomyosarcoma. Magnetic resonance imaging features with pathological correlation. J Comput Assist Tomogr. 27(5):805-9, 2003
                                                                                      15. Kido A et al: Diffusely enlarged uterus: evaluation with MR imaging. Radiographics. 23(6):1423-39, 2003
                                                                                      16. Rha SE et al: CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 181(5):1369-74, 2003
                                                                                      17. Szklaruk J et al: MR imaging of common and uncommon large pelvic masses. Radiographics. 23(2):403-24, 2003
                                                                                      18. Goto A et al: Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer. 12(4):354-61, 2002
                                                                                      19. Ohara N. Related Articles et al: A comparison of MRI findings of uterine leiomyosarcoma before surgery and at recurrence. J Obstet Gynaecol. 22(1):99, 2002