Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings

Tanaka, Yumiko; Nishida, Masato; Tsunoda, Hajime; Okamoto, Yoshikazu; Yoshikawa, Hiroyuki

doi:10.1002/jmri.20207

Cited by 189 publications

(124 citation statements)

References 19 publications

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“…It has been shown that high signal intensity and ill-defined margins are very often encountered, but neither is a reliable indicator of malignancy [30,31].…”

Section: Discussionmentioning

confidence: 99%

Power morcellation for women undergoing laparoscopic supracervical hysterectomy — safety of procedure and clinical experience from 426 cases

et al. 2016

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Objectives: Minimally invasive gynaecological surgeries are performed for several malignant and nonmalignant indications. The aim of our study was to evaluate the rate of unexpected malignancies among women who underwent laparoscopical supracervical hysterectomy (LASH) with power morcellation. Material and methods:The retrospective analysis included clinical data of 426 consecutive female patients who underwent LASH with power morcellation due to presumed benign disorders (78.4% -symptomatic uterine fibromas, 12.7% -abnormal uterine bleeding, 8.9% -suspicion of uterine adenomyosis) between January 2011 and December 2015. Premalignant or malignant preoperative abnormalities in the cervix and the uterine corpus were contraindications for LASH. Results:The unexpected malignancies were found in four patients from study group: one ovarian cancer located on the inner part of simple ovarian cyst and 3 endometrial carcinomas (0.9%) were documented. All these patients underwent abdominal reoperations and no histological abnormalities were detected in the extirpated cervix and adnexa. Conclusions:The incidence of unintended endometrial carcinoma in morcellated uterus after LASH was relatively small. However, careful pre-operative counseling should be undertaken in order to exclude the possibility of any malignant disease in uteri among women scheduled to power morcellation.

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“…It has been shown that high signal intensity and ill-defined margins are very often encountered, but neither is a reliable indicator of malignancy [30,31].…”

Section: Discussionmentioning

confidence: 99%

Power morcellation for women undergoing laparoscopic supracervical hysterectomy — safety of procedure and clinical experience from 426 cases

et al. 2016

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“…tumor necrosis www.fhc.viamedica.pl factor a [TNF-a] or interleukin-1). The genes regulated by NF-kB involve those coding for cytokines, including interleukin-1b (IL-1b), interleukin-6 (IL-6) or TNF-a, and genes coding for anti-apoptotic proteins or proteins which control cell proliferation [4,[6][7][8]. They also include genes coding for cyclooxygenase 2 (COX-2) and inducible nitric oxide synthase (iNOS) [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical localization of selected pro-inflammatory factors in uterine myomas and myometrium in women of various ages

Plewka

Madej

Plewka

et al. 2013

Folia Histochem Cytobiol.

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Uterine myomas represent one of the most frequently manifested benign tumors in women. They originate from smooth muscle cells of myometrium or its blood vessels. Many studies suggest that inflammation and pro-inflammatory factors may play a role in the carcinogenesis with an involvement of the transcription factor NF-kB which activity can be controlled by various environmental factors, including many cytokines. The aim of the study was to investigate the expression of NF-B, interleukin-1b (IL-1b), tumor necrosis factor a (TNF-a), cyclooxygenase 2 (COX-2) and inducible nitric oxide synthase (iNOS) in myometrium and uterine myomas of women of various age. The expression of NF-kB, selected cytokines and enzymes was estimated in women of reproductive or perimenopausal age by semiquantitative immunohistochemistry. The expression of the examined proteins was higher in myomas than in control myometrium and was dependent on the size of myomas and the age of women. However, the expression of the cytoplasmic NF-kB observed in uterine myomas was independent on the size of myomas and no significant differences were observed in the number of stained nuclei between control and myoma groups. Thus, the expression of proinflammatory factors in myomas was not accompanied by the nuclear activation of NF-kB p65. The results of our study indicate that the examined factors may be involved in the pathogenesis of benign tumors and not only malignant diseases.

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“…Typical MR characteristics of benign uterine leiomyomas include well-demarcated, homogenous, hypointense areas on T1 and T2-weighted images. Identification of a leiomyosarcoma remains difficult, although large heterogeneous masses with any areas of hyperintensity on T2 images, suggesting hemorrhage or coagulative necrosis, are thought to indicate sarcoma [5]- [7]. One small study found that the highest diagnostic accuracy in the diagnosis of malignant nonmyomatous uterine tumors occurred when three criteria were met: 1) a majority of the tumor had high signal intensity on T2 images; 2) areas of hyperintensity on T1 images; 3) and areas of non-enhancement following contrast administration [5].…”

Section: Discussionmentioning

confidence: 99%

Revisiting Imaging and Pathology of Malignant Appearing Uterine Smooth Muscle Tumors: A Mistaken Identity of Leiomyosarcoma on MRI

Juhl¹,

Knuttinen²,

Kothari³

et al. 2014

OJRad

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Uterine leiomyoma is a relatively common condition occurring in a majority of African American and Caucasian women by age 50. Magnetic resonance imaging of the pelvis with contrast is the modality of choice when evaluating uterine tumors. We report a case of a patient with a four-day history of intra-menstrual vaginal bleeding who underwent magnetic resonance imaging of the pelvis that suggested the tumor was a leiomyosarcoma, the malignant counterpart of leiomyoma. Therefore, the patient underwent pre-operative uterine artery embolization to decrease blood loss with exploratory laparotomy, resection of pelvic mass and dilation and curettage. Pathologic evaluation of the mass returned a diagnosis of leiomyoma. Magnetic resonance imaging evaluation of leiomyomata remains difficult. Further development of imaging parameters could improve diagnosis of benign uterine fibroids.

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Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings

Cited by 189 publications

References 19 publications

Power morcellation for women undergoing laparoscopic supracervical hysterectomy — safety of procedure and clinical experience from 426 cases

Power morcellation for women undergoing laparoscopic supracervical hysterectomy — safety of procedure and clinical experience from 426 cases

Immunohistochemical localization of selected pro-inflammatory factors in uterine myomas and myometrium in women of various ages

Revisiting Imaging and Pathology of Malignant Appearing Uterine Smooth Muscle Tumors: A Mistaken Identity of Leiomyosarcoma on MRI

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