TITLE:
Revisiting Imaging and Pathology of Malignant Appearing Uterine Smooth Muscle Tumors: A Mistaken Identity of Leiomyosarcoma on MRI
AUTHORS:
Mark Juhl, Martha-Gracia Knuttinen, Rajul Kothari, John Groth
KEYWORDS:
Magnetic Resonance Imaging, Uterine Fibroid Embolization, Fibroid, Leiomyoma, Leiomyosarcoma
JOURNAL NAME:
Open Journal of Radiology,
Vol.4 No.2,
May
27,
2014
ABSTRACT: 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.