Endometrial stromal tumours
Endometrial stromal tumours (EST) are an uncommon group of tumours arising from endometrial stromal cells. It accounts for <2% of all uterine malignancies and 10% of all uterine sarcomas.
Half occur in premenopausal women, with most patients presenting in the 5th decade.
The symptoms are non specific and include menorrhagia, abdominal pain or a palpable pelvic mass.
Over the past four decades, EST classification has gone through various modifications starting from the earliest study by Norris and Taylor. This was primarily due to the rarity of the tumours. With better understanding, and at the time of writing (mid 2016), the 2014 WHO classification has replaced the broad categories of the 2003 WHO classification following incorporation of molecular findings.
Lesions can be of mixed echotexture 3.
Features reported to be more prevalent in EST include 1:
- irregular margin(s)
- nodular lesions at the margin(s)
- intra-myometrial nodular extension
- multiple nodular mass formation
- tumour extension along the vessels or ligaments (considered characteristic 5)
- T2: may show bands of low signal (representing preserved bundles of myometrium) within the areas of myometrial involvement
- 1. Ueda M, Otsuka M, Hatakenaka M et-al. MR imaging findings of uterine endometrial stromal sarcoma: differentiation from endometrial carcinoma. Eur Radiol. 2001;11 (1): 28-33. Eur Radiol (link) - Pubmed citation
- 2. Furukawa R, Akahane M, Yamada H et-al. Endometrial stromal sarcoma located in the myometrium with a low-intensity rim on T2-weighted images: report of three cases and literature review. J Magn Reson Imaging. 2010;31 (4): 975-9. doi:10.1002/jmri.22126 - Pubmed citation
- 3. Gandolfo N, Gandolfo NG, Serafini G et-al. Endometrial stromal sarcoma of the uterus: MR and US findings. Eur Radiol. 2000;10 (5): 776-9. Eur Radiol (link) - Pubmed citation
- 4. Rha SE, Byun JY, Jung SE et-al. CT and MRI of uterine sarcomas and their mimickers. AJR Am J Roentgenol. 2003;181 (5): 1369-74. AJR Am J Roentgenol (full text) - Pubmed citation
- 5. Koyama T, Togashi K, Konishi I et-al. MR imaging of endometrial stromal sarcoma: correlation with pathologic findings. AJR Am J Roentgenol. 1999;173 (3): 767-72. AJR Am J Roentgenol (abstract) - Pubmed citation