Can gray‐scale and color Doppler sonography differentiate between uterine leiomyosarcoma and leiomyoma?

Exacoustòs, C.; Romanini, M. E.; Amadio, A.; Amoroso, C.; Szabolcs, B.; Zupi, Errico; Arduini, Domenico

doi:10.1002/jcu.20386

Cited by 117 publications

(88 citation statements)

References 39 publications

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“… onset of uterine masses in postmenopausal women;  rapid increase in size (> 6 weeks in 9-12 months) [30] ;  failure of feedback to the treatment with GnRH analogues;  high levels of total LDH, and / or isoforms (3, 4 and/or 5);  high levels of Ca125;  presence of central and peripheral vasculature, with a low flow resistance, high systolic peak at echo-color Doppler examination (ECD) [31] .…”

Section: Inclusion Criteriamentioning

confidence: 99%

“…Although ultrasound represents the first instance investigation in the study for imaging of the female pelvis, it has some limitations in revealing large tumors, due to a limited field of view, and in tissue characterization; moreover there is a significant overlap between the sonographic appearance of degenerated leiomyomas and that of the sarcomas [12][13][14][15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

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The contribution of Magnetic Resonance Imaging in the differential diagnosis between leiomyoma typical, atypical and uterine sarcomas: Personal experience

Tamburrini

Smiraglio

Caputo

et al. 2016

IJDI

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Purpose: Evaluate the role of Magnetic Resonance Imaging (MRI) in the differential diagnosis between degenerated leiomyomas, cellular leiomyomas and uterine sarcomas. Materials and methods:From February 2015 to August 2015, 42 patients were enrolled, aged between 18 and 75 years, suffering from uterine "mass" waiting for surgery and considered at risk and/or uncertain clinical and laboratory investigations and imaging. These patients were submitted to MRI exam of the pelvis that was performed by morphological study, DWI sequences and dynamic sequences post-contrastographic. Results:The analysis of MRI images of the 42 patients made possible to do a diagnosis of uterine sarcomas in 8 patients with the aid of sequences weighted in diffusion and dynamic, proving a sensitivity of 100% and a specificity of 88%. Conclusions:Based on our experience, we may consider that by morphological study with DWI sequences weighted in diffusion and dynamic post-contrastographic sequences, the MRI is a working aid in the differential diagnosis between degenerated leiomyomas and uterine sarcomas.

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Section: Inclusion Criteriamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The contribution of Magnetic Resonance Imaging in the differential diagnosis between leiomyoma typical, atypical and uterine sarcomas: Personal experience

Tamburrini

Smiraglio

Caputo

et al. 2016

IJDI

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“…The largest series published comparing the ultrasound appearance of uterine leiomyosarcomas with that of benign leiomyomas includes eight leiomyosarcomas and 225 benign leiomyomas [30]. The menopausal status of the women in the study cited was not reported.…”

Section: Uterine Leiomyosarcomamentioning

confidence: 99%

“…The ultrasound appearance of uterine leiomyosarcomas has been described but not separately for pre-and post-menopausal women [30]. Whether magnetic resonance imaging is superior to ultrasound for distinguishing leiomyosarcomas from leiomyomas is currently not known, see above.…”

Section: Uterine Leiomyosarcomamentioning

confidence: 99%

Imaging techniques in the management of abnormal vaginal bleeding in non-pregnant women before and after menopause

Valentin

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

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Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding ultrasound is used to categorize women as being at low or high risk of endometrial cancer, the result of the ultrasound examination being the basis for further management. In women with abnormal vaginal bleeding before menopause the role of ultrasound is less clear, because some common causes of abnormal vaginal bleeding before menopause cannot be diagnosed with ultrasound, e.g. infection, dysfunctional bleeding or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may sometimes be helpful also in women with abnormal vaginal bleeding before menopause. In this chapter ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas including submucuous myomas, and leiomyosarcoma will be presented and ultrasound based triage of women with postmenopusal bleeding described. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 2 AbstractTransvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding ultrasound is used to categorize women as being at low or high risk of endometrial cancer, the result of the ultrasound examination being the basis for further management. In women with abnormal vaginal bleeding before menopause the role of ultrasound is less clear, because some common causes of abnormal vaginal bleeding before menopause cannot be diagnosed with ultrasound, e.g. infection, dysfunctional bleeding or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may sometimes be helpful also in women with abnormal vaginal bleeding before menopause. In this chapter ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas including submucuous myomas, and leiomyosarcoma will be presented and ultrasound based triage of women with postmenopusal bleeding described.

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“…Exacoustos et al [7] compared gray-scale and color Doppler sonography for ability to differentiate between uterine LMS and leiomyoma [7]. The preoperative gray-scale and color Doppler sonographic findings of 8 patients with LMS, 21 patients with cellular leiomyomas, and 3 patients with smooth muscle tumors of uncertain malignant potential were obtained and compared with images of 225 patients with benign leiomyomas.…”

Section: Evaluation Of the Uterine Massmentioning

confidence: 99%

Predicting Gynecological Malignancy at Surgery: Magic 8 Ball, or Paradigm Shift?

Chapa¹

2014

J Clin Case Rep

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In medical school, future physicians are taught the phrase "primum non nocere", first do no harm. That adage motivates every physician, every healthcare provider, to go to great lengths to avoid an incorrect diagnosis for a patient. As a gynecological surgeon, that adage is put to the test with every operative patient dealing with a pelvic mass. Encountering an undiagnosed malignancy during and anticipated benign surgical intervention is stressful for the surgeon, but devastating to the unprepared patient. Recently, attention has focused on uterine morcellation at time of laparoscopic hysterectomy. Stemming from the inadvertent morcellation of a leiomyosarcoma in a patient presumed to have been benign fibroids, the question has arisen of informed consent disclosures versus the appropriateness of a selected surgery when the possibility of a malignancy exists (WSJ Dec 2013).

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Can gray‐scale and color Doppler sonography differentiate between uterine leiomyosarcoma and leiomyoma?

Abstract: The findings of the present study suggest that the detection of hypervascularity in combination with other sonographic findings can identify suspicious uterine smooth muscle tumors that will require additional diagnostic evaluation before treatment.

Cited by 117 publications

References 39 publications

The contribution of Magnetic Resonance Imaging in the differential diagnosis between leiomyoma typical, atypical and uterine sarcomas: Personal experience

The contribution of Magnetic Resonance Imaging in the differential diagnosis between leiomyoma typical, atypical and uterine sarcomas: Personal experience

Imaging techniques in the management of abnormal vaginal bleeding in non-pregnant women before and after menopause

Predicting Gynecological Malignancy at Surgery: Magic 8 Ball, or Paradigm Shift?

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