MR Detection of Degenerating Uterine Leiomyomas

Okizuka, Hiromi; Sugimura, Kazuro; Takemori, Masayuki; Obayashi, Chiho; Kitao, Manabu; Ishida, Tetsuya

doi:10.1097/00004728-199309000-00018

Cited by 86 publications

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“…19 However, because leiomyomas with degeneration can have an appearance that mimics leiomyosarcomas, the differential diagnosis between these tumors is difficult. 7,19 In the current study the positive predictive value of MRI evaluation for distinguishing uterine sarcomas from leiomyomas based on such characteristics was low (approximately 10%). In contrast, the negative predictive value was high (100% in those patients who underwent surgery or who were followed for Ն 2 years).…”

Section: Discussionmentioning

confidence: 54%

“…Magnetic resonance imaging (MRI) has proven to be one of the most useful imaging modalities in making the preoperative differentiation between these tumors, but even with MRI it is difficult to distinguish between uterine sarcomas and uterine leiomyomas with degeneration. 6,7 The most reliable preoperative diagnostic method is a biopsy of the tumor. However, routine endometrial biopsy will not provide a correct diagnosis unless the tumor has reached the surface of the endometrial cavity, with a low sensitivity of approximately 30%.…”

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confidence: 99%

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Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma

Kawamura

Ichimura

Ito

et al. 2002

Cancer

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BACKGROUNDThe clinical differential diagnosis between uterine sarcoma and benign leiomyoma is difficult even with magnetic resonance imaging (MRI). Therefore, a considerable number of patients have undergone hysterectomies due to an indication of “suspected malignancy” based on tumor size alone. However, approximately 80% of these hysterectomies have been judged to have been recommended inappropriately. In such situations, reliable preoperative diagnostic tests are required. The authors have evaluated the accuracy of needle biopsy for uterine myoma‐like tumors, a procedure that to the authors' knowledge has been performed infrequently.METHODSTranscervical needle biopsy was performed in 435 patients with uterine myoma‐like tumors. The biopsy specimens were scored for degree of malignancy according to the histopathologic criteria proposed by Bell et al. Histopathologic evaluation of surgical specimens and clinical outcome after 2 years of follow‐up were used as the reference standards.RESULTSOf 435 patients, 7 had uterine sarcomas, 4 of which were scored as ≥ 4 points and were diagnosed as “sarcoma” by needle biopsy alone. No sarcoma cases were included in the group of patients with a score of 0. The cutoff score combining the highest sensitivity and specificity with respect to distinguishing uterine leiomyosarcoma from uterine leiomyoma was 2; sensitivity, specificity, and positive and negative predictive values were 100%, 98.6%, 58%, and 100.0%, respectively.CONCLUSIONSTranscervical needle biopsy using histopathologic scoring is a reliable diagnostic test for the differential diagnosis between uterine sarcoma and leiomyoma. This diagnostic method, combined with MRI screening, could reduce the number of patients currently undergoing unnecessary surgery. Cancer 2002;94:1713–20. © 2002 American Cancer Society.DOI 10.1002/cncr.10382

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Section: Discussionmentioning

confidence: 54%

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confidence: 99%

Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma

Kawamura

Ichimura

Ito

et al. 2002

Cancer

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“…[1][2][3] Uterine sarcomas are rare and have a poor prognosis. [4] Both present as focal masses in the uterine myometrium.…”

Section: Discussion Of Managementmentioning

confidence: 99%

Fibroid Mimicking Sarcoma

Kalpana¹,

Gupta²

2017

jemds

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“…As fibroids enlarge, they outgrow their blood supply causing various types of degeneration, most commonly hyaline (60%), cystic (4%), red (3%), calcareous (4%) or sarcomatous degeneration (0.1-0.8%). [3][4][5][6][7] The typical clinical findings and ultrasonography appearance of a uterine fibroid are obscured by the degenerative changes. This report exemplifies how misleading the diagnosis could be with the fibroid degeneration.…”

Section: Introductionmentioning

confidence: 99%

Degenerated fibroid - a diagnostic challenge

Bhuyar

Sontakke

Rajbhara

2016

Int J Reprod Contracept Obstet Gynecol

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Leiomyoma of the uterus is the most common type of tumor affecting the female pelvis and arises from uterine smooth muscle. The size of leiomyoma varies from microscopic to giant; giant myoma is exceedingly rare. We report an unusual case of a large, cystic, uterine leiomyoma mimicking a primary malignant ovarian tumor on sonography and CT. A 39 year old infertile nulliparous woman presented with a history of lump in abdomen since 2 years and 6 months of amenorrhea. Sonography and CT examination showed a large mass that filled the abdomen. A preoperative diagnosis of a primary malignant ovarian tumor was made. The patient underwent laparotomy with total abdominal hysterectomy preserving tubes and ovaries. The histology revealed a leiomyoma with extensive hyaline degeneration. The current established management of uterine fibroids may include expectant, surgical, or medical management or uterine artery embolization or a combination of these treatments. A surgical approach is preferred for management of giant leiomyomas. Leiomyomas should be considered in the differential diagnosis of a multilocular and predominantly cystic adnexal mass.

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MR Detection of Degenerating Uterine Leiomyomas

Cited by 86 publications

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Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma

Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma

Fibroid Mimicking Sarcoma

Degenerated fibroid - a diagnostic challenge

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