We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Improving preoperative identification of uterine sarcomas: analysis of clinical and imaging characteristics.
- Authors
Sojin Shin; Seungmee Lee; Changmin Shin; Hyewon Chung; Tae-Kyu Jang; Sang-Hoon Kwon; Chi-Heum Cho
- Abstract
Objective: Distinguishing uterine sarcomas from leiomyomas preoperatively poses a significant challenge. This study aims to analyze patient characteristics in cases where uterine sarcoma was suspected prior to surgery. Methods: A retrospective review of medical records (2018-2023) was conducted, focusing on patients who underwent pelvis magnetic resonance imaging (MRI) for uterine masses with suspected sarcoma or due to clinical indications of the disease. Analyzed factors included age, preoperative imaging (particularly pelvis MRI), and preoperative and postoperative diagnoses. Results: Out of the 95 patients meeting inclusion criteria, 52 were suspected of sarcoma via pelvis MRI for uterine mass, while 43 underwent MRI due to clinical suspicion. Postoperative diagnoses revealed 15 malignant cases, including endometrial stromal sarcoma (n=6), leiomyosarcoma (n=3), poorly differentiated sarcoma (n=1), endometrial cancer (n=2), and lymphoma (n=3). During the same period, 21 patients were diagnosed with uterine sarcoma postoperatively. Misdiagnoses as leiomyoma were common in younger patients, with an age difference observed between those suspected (50.1 years) and not suspected (44.9 years) of sarcoma preoperatively. Single, large tumors (>5 cm) were significant predictors of sarcoma (p<0.05). MRI proved the most effective in diagnosing sarcoma, with 60% accuracy, compared to a 76.4% misdiagnosis rate when solely relying on ultrasonography. Six patients required re-staging surgery due to incomplete initial staging following myomectomy, revealing peritoneal seeding in two leiomyosarcoma cases. Conclusion: Uterine sarcomas, often misdiagnosed as leiomyomas, tended to be in younger patients with smaller (<5 cm) or multiple tumors, primarily evaluated using only ultrasonography. Comprehensive assessments, including MRI, are recommended for accurate differentiation of uterine sarcomas in women with uterine mass.
- Subjects
UTERINE cancer; IMAGE analysis; DIAGNOSTIC imaging; MYOMECTOMY; MAGNETIC resonance imaging; MULTIPLE tumors; SMOOTH muscle tumors; LEIOMYOSARCOMA
- Publication
Journal of Gynecologic Oncology, 2024, Vol 35, p14
- ISSN
2005-0380
- Publication type
Article
- DOI
10.3802/jgo.2024.35.S2.FP-U3