Carcinosarcoma of the Uterus: Magnetic Resonance Imaging

Abstract

We report the magnetic resonance imaging (MRI) findings with a paramagnetic enhancement agent (gadopentetate dimeglumine (Gd-DTPA)) in a 70-year-old woman with carcinosarcoma of the uterus. In the present patient, the polypoid portion histologically most abundant in the sarcomatous component was strongly enhanced by Gd-DTPA and was clearly demonstrated with high signal intensities on contrast-enhanced Ti -weighted images. We suggest that MRI with Gd-DTPA may be clinically useful for detection of carcinosarcoma, and that any patient having endometrial carcinoma with the polypoid portion, which is more strongly enhanced by Gd-DTPA within the tumor, may be suspected of carcinosarcoma.

Carcinosarcoma of the uterus: radiologic–pathologic correlations with magnetic resonance imaging including diffusion-weighted imaging

“…On T2-weighted images, carcinosarcomas show heterogeneous moderate to high intensity, where the highest intensity represents necrosis and hemorrhage [4,7]. On contrast-enhanced T1-weighted images, carcinosarcoma typically demonstrates heterogeneous enhancement, and although the sarcomatous components of the polypoid portions are often more strongly enhanced than those of adenocarcinoma, necrotic regions of the sarcomatous components show no or weak enhancement [8]. Reflecting sarcomatous components with prominent vascularity, dynamic MRI showed marked enhancement during the early phase and maintained this enhancement to the delayed phase and/or showed gradual and delayed strong enhancement [3].…”

Combined diagnostic imaging of uterine carcinosarcoma: A case report

“…They did not find any MR features specific to uterine carcinosarcoma and suggested that these characteristics simulated those of invasive endometrial carcinoma. Takemori et al (4) , however, reported a case in which Gd‐DTPA strongly enhanced a polypoid portion within the tumor and suggested that MR with Gd‐DTPA might be clinically useful for diagnosing uterine carcinosarcoma. In the present case, the MR findings were similar to those reported by Worthington et al (2) and Shapeero et al (3) .…”

MR Imaging of Common and Uncommon Large Pelvic Masses

“…Carcinosarcoma may metastasize to pelvic and paraaortic lymph nodes, pelvic soft tissues, the vagina, peritoneal surfaces, and the lungs. These tumors have variable signal intensity on T2-weighted MR images (14). On contrastenhanced images, carcinosarcoma typically demonstrates heterogeneous enhancement, with the polypoid portion of the tumor showing intense enhancement ( Fig 6).…”