EURORAD ESR

Case 10213

Undifferentiated endometrial sarcoma: MR imaging findings with pathologic correlation

Author(s)
Alexandra Ntorkou1, Athina C. Tsili1, Maria I. Argyropoulou1, Anna Gousia2, Konstantinos Tsampoulas1.

1) Department of Clinical Radiology; 2) Department of Pathology; University Hospital of Ioannina, Greece.

University Hospital of Ioannina, Clinical Radiology, Dept. Of Radiology
Pl. Patgis 2 45332 Ioannina, Greece
Email:a_tsili@yahoo.gr
 
Patient
female, 72 year(s)
 
 
  • Figure 1
    MRI examination
     

    Sagittal T2-weighted image depicts a polypoid, ill-defined heterogeneous endometrial mass, with extensive myometrial infiltration. Cervical involvement is also seen.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Transverse T2-weighted image shows bulky lobulated, inhomogeneous intracavitary mass, invading most of the myometrium. Hypointense bands (arrows) are seen within areas of myometrial invasion, corresponding to...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Transverse T1-weighted image demonstrates uterine enlargement. The neoplasm has signal intensity predominantly similar to that of normal myometrium. Hyperintense area (arrowhead) within the mass corresponds to...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    MRI DWI examination
     

    Transverse DW image demonstrates the tumor as an area of hyperintensity.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Corresponding ADC map (b700 s/mm2) shows the tumor with low signal intensity and an ADC value of 0.82 mm2/s.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    MRI post contrast examination

    Sagittal fat-suppressed post-contrast T1-weighted image depicts inhomogeneous tumour enhancement, less than that of normal myometrium. Non-enhanced parts of the tumor (asterisk) represented areas of necrosis...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Pathology
     

    Histologic section of the tumour showing fascicles of neoplastic spindle cells (H/E X100).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Highly atypical cells with numerous mitoses (H/E X400).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
Sagittal T2-weighted image depicts a polypoid, ill-defined heterogeneous endometrial mass, with extensive myometrial infiltration. Cervical involvement is also seen.
 
Transverse T2-weighted image shows bulky lobulated, inhomogeneous intracavitary mass, invading most of the myometrium. Hypointense bands (arrows) are seen within areas of myometrial invasion, corresponding to preserved bundles of myometrium on pathology.
 
Transverse T1-weighted image demonstrates uterine enlargement. The neoplasm has signal intensity predominantly similar to that of normal myometrium. Hyperintense area (arrowhead) within the mass corresponds to haemorrhagic focus on histology.
 
Transverse DW image demonstrates the tumor as an area of hyperintensity.
 
Corresponding ADC map (b700 s/mm2) shows the tumor with low signal intensity and an ADC value of 0.82 mm2/s.
 
Sagittal fat-suppressed post-contrast T1-weighted image depicts inhomogeneous tumour enhancement, less than that of normal myometrium. Non-enhanced parts of the tumor (asterisk) represented areas of necrosis pathologically
 
Histologic section of the tumour showing fascicles of neoplastic spindle cells (H/E X100).
 
Highly atypical cells with numerous mitoses (H/E X400).
 
 
 
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