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- Title
Low-Grade Endometrial Stromal Sarcoma with a Nodule-in-Nodule Appearance in Preoperative Magnetic Resonance Images.
- Authors
Nakamura, Mitsuhiro; Murakami, Ryusuke; Abiko, Kaoru; Miyamoto, Taito; Kitawaki, Yoshimi; Yamaguchi, Ken; Horie, Akihito; Hamanishi, Junzo; Kodoh, Eiji; Baba, Tsukasa; Kido, Aki; Minamiguchi, Sachiko; Matsumura, Noriomi; Mandai, Masaki
- Abstract
Low-grade endometrial stromal sarcoma (LG-ESS) is a rare malignant disease and demonstrates various patterns in preoperative imaging. Therefore, accurate diagnosis is important. Given its unique form, we report a case of LG-ESS with a nodule-in-nodule appearance on preoperative imaging. A 41-year-old woman was referred to our department for further examination of a 45 mm diameter uterine corpus mass. Preoperative magnetic resonance imaging (MRI) revealed several small nodules within a larger nodule. T2-weighted images showed moderate-to-high signal intensity with focal bands of low signal intensity in the small nodules. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological findings of the small nodules showed densely concentrated endometrial stromal cells reminiscent of a proliferative phase endometrium with a concentric arrangement of small spiral arteriole-like vessels. The small nodules exhibited an expansile growth pattern and were surrounded by less densely concentrated endometrial stromal cells intermingled with the normal uterine myometrium. LG-ESS with smooth muscle differentiation and sex cord-like elements was partially observed. In summary, LG-ESS demonstrating a unique nodule-in-nodule appearance on preoperative imaging histopathologically comprised tumor cells of varying densities. Our current case suggests that preoperative diagnostic imaging with MRI may be useful.
- Subjects
MAGNETIC resonance imaging; SARCOMA; HYSTERO-oophorectomy; SEX differentiation (Embryology); STROMAL cells; ENDOMETRIAL hyperplasia; ENDOMETRIAL tumors
- Publication
Case Reports in Obstetrics & Gynecology, 2020, p1
- ISSN
2090-6684
- Publication type
Article
- DOI
10.1155/2020/8973262