Uterine sarcoma

Case contributed by Dr Khalid Alhusseiny

Presentation

Post-menoupausal bleeding.

Patient Data

Age: 70 years
Gender: Female
MRI

The endometrial cavity is distended by a well-defined mass with heterogeneous signal intensity on different pulse sequences, heterogeneous post-contrast enhancement and significant diffusion restriction of its major bulk.

Multiple bilateral pelvic and iliac lymph nodes are seen showing restricted diffusion.

Multiple small myometrial interstitial and subserosal myomas are seen.

Spondylo-degenerative changes are seen involving the lumbar spine with multi-level disc protrusions.

Photo

Surgical pathology report.

Case Discussion

Uterine adenosarcoma is a rare malignancy usually originating from the endometrium. The peak incidence is at 50-60 years of age. Hystrectomy is considered treatment of choice.

It is composed of both sarcomatous stroma (usually low-grade) and benign epithelium (usually endometrium-like cells). Mortality may reaches 75% in cases of sarcomatous overgrowth which is defined as the presence of sarcomatous part representing more than 25% of the tumor volume.

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Case information

rID: 85235
Published: 19th Dec 2020
Last edited: 21st Dec 2020
Inclusion in quiz mode: Included