MR Imaging of Uterine Adenosarcoma: Case Report and Literature Review

Yoshizako, Takeshi; Wada, Akihiko; Kitagaki, Hajime; Ishikawa, Noriyuki; Miyazaki, Kohji

doi:10.2463/mrms.10.251

Cited by 21 publications

(22 citation statements)

References 9 publications

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“…3Y6 There have been a few case reports of magnetic resonance imaging, which typically shows an endometrial cavity distended by a polypoid mass that has solid components with high signal intensity compared with the myometrium on both sequences, small cystic areas, and similar enhancement to the myometrium after administration of gadolinium. 12 Approximately 20% to 30% of adenosarcomas arise in extrauterine sites including the vagina, fallopian tube, pouch of Douglas, and ovary, and these have no specific clinical features and are diagnosed pathologically. 3Y6,13 In the largest series of ovarian adenosarcomas, the tumors were unilateral and ranged in size from 5 to 50 cm, and abdominal discomfort was the usual presenting symptom.…”

Section: Clinical Presentationmentioning

confidence: 99%

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Mullerian Adenosarcoma of the Female Genital Tract

Friedlander

Covens

Glasspool

et al. 2014

Int J Gynecol Cancer

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Mullerian adenosarcomas of the female genital tract are rare malignancies, originally described in the uterus, the most common site of origin, but they may also arise in extrauterine locations. Uterine adenosarcomas make up 5% of uterine sarcomas and tend to occur in postmenopausal women. They are usually low-grade tumors and are characterized by a benign epithelial component with a malignant mesenchymal component, which is typically a low-grade endometrial stromal sarcoma but can also be a high-grade sarcoma. Tumors that exhibit a high-grade sarcomatous overgrowth have a worse outcome. Adenosarcomas have been described as being midway along the spectrum between benign adenofibromas and carcinosarcomas. They generally have a good prognosis with the exception of deeply invasive tumors or those with high-grade sarcomatous overgrowth. Extrauterine adenosarcomas also have a higher risk for recurrence. In view of their rarity, there have not been any clinical trials in mullerian adenosarcomas and relatively little research. This article reviews the current knowledge and provides recommendation for the management of mullerian adenosarcomas.

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Section: Clinical Presentationmentioning

confidence: 99%

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Mullerian Adenosarcoma of the Female Genital Tract

Friedlander

Covens

Glasspool

et al. 2014

Int J Gynecol Cancer

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“…After administration of gadolinium, there is heterogeneous enhancement, with solid components of the mass showing enhancement similar to that of the myometrium (Fig. 6b) (3,20,21).…”

Section: Mri Featuresmentioning

confidence: 99%

“…However, on DWI, they usually show relatively low signal intensity on high b-value, reflecting its low grade nature (21,22).…”

Section: Mri Featuresmentioning

confidence: 99%

“…Adenosarcoma is typically seen as a large well-demarcated polypoid mass arising within the endometrial cavity and protruding through the cervical os, causing marked enlargement of the uterus with a thin myometrium (3,20,21). This polypoid mass usually shows a multiseptated cystic appearance, with multiple heterogeneous solid components that fill the endometrial cavity, and may mimic the appearance of gestational trophoblastic disease (Fig.…”

Section: Mri Featuresmentioning

confidence: 99%

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Uterine sarcomas: clinical presentation and MRI features

Santos

Cunha²

2015

Diagn Interv Radiol

155

138

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Uterine sarcomas are a rare heterogeneous group of tumors of mesenchymal origin, accounting for approximately 8% of uterine malignancies. They comprise leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, and adenosarcoma. Compared with the more common endometrial carcinomas, uterine sarcomas behave more aggressively and are associated with a poorer prognosis. Due to their distinct clinical and biological behavior, the International Federation of Gynecology and Obstetrics introduced a new staging system for uterine sarcomas in 2009, categorizing uterine carcinosarcoma as a variant of endometrial carcinoma, rather than a pure sarcoma. Magnetic resonance imaging (MRI) has a developing role in the assessment of these malignancies. Features such as tumor localization, irregular or nodular margins, necrosis, rapid growth, intense contrast enhancement, and restriction at diffusion-weighted imaging can suggest the diagnosis and help differentiate from more common leiomyomas and endometrial carcinoma. MRI is therefore extremely useful in preoperative detection and staging and, consequently, in determination of appropriate management. This pictorial review aims to discuss the clinical features of uterine sarcomas, as well as their most common appearances and distinct characteristics in MRI.

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“…Adenosarcomas are usually low grade tumours and typically present as polyps. They have been shown to have low ADC values in the limited studies available [33,34] . Overall studies trying to differentiate leiomyoma from sarcomas in terms of ADC values alone have been inconsistent with considerable overlap in values, ADC could be used as a adjuvant tool along with other parameters to increase the diagnostic confidence to characterize benign from malignant lesions [31][32][33][34][35][36][37] .…”

Section: Uterine Sarcomasmentioning

confidence: 99%

Diffusion weighted imaging in gynecological malignancies - present and future

Manoharan¹,

Das²,

Aggarwal³

et al. 2016

WJR

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The management of gynaecological malignancies has undergone a significant change in recent years with our improved understanding of cancer biogenetics, development of new treatment regimens and enhanced screening. Due to the rapid blooming of newer methods and techniques in gynaecology, surgery and oncology the scope and the role of imaging has also widened. Functional imaging in the form of diffusion weighted imaging (DWI) has been recently found to be very useful in assessing various tumours. Its ability to identify changes in the molecular level has dramatically changed the diagnostic approach of radiologists which was solely based on morphological criteria. It can improve the diagnostic accuracy of conventional magnetic resonance imaging, lend a hand in assessing tumour response to treatment regimens and detect tumour recurrence with better spatial resolution, negative radiation and diagnostic accuracy compared to positron emission tomography scan. The ability to quantify the diffusion has also lead to potential prediction of tumour aggressiveness and grade which directly correlate with the patient prognosis and management. Hence, it has become imperative for a radiologist to understand the concepts of DWI and its present and evolving role. In this article we present a brief description of the basics of DWI followed by its role in evaluation of female gynaecological malignancies. Core tip: With rapidly evolving strategies in the management of the gynaecological malignancies today there is an increasing role of imaging to keep up with the pace of development and develop newer techniques which help in better management of the patient. Diffusion weighted imaging (DWI) is one such modality which helps in detecting changes at the molecular level and hence can help in better diagnosis of early cancers as well as in assessing response to treatment.

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MR Imaging of Uterine Adenosarcoma: Case Report and Literature Review

Cited by 21 publications

References 9 publications

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Mullerian Adenosarcoma of the Female Genital Tract

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Mullerian Adenosarcoma of the Female Genital Tract

Uterine sarcomas: clinical presentation and MRI features

Diffusion weighted imaging in gynecological malignancies - present and future

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