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The journal «ONCOSURGERY» 2013, Vol.5, No 4

Correlation of echography, magnetic resonance imaging and morphological data for uterine sarcoma-like leiomyoma

Trophimenko IA1,2, Bergen TA3, Isakova NB4, Baklanova NS4, Krasilnikov SE4

1) Military medical academy named by S.M. Kirov, Saint-Petersburg, Russia
2) City hospital №40, Sestroretsk, Russia
3) Novosibirsk Railway Clinical Hospital on Novosibirsk-glavnyi station, JSCo "RZD",
4) Novosibirsk Regional Oncological Dispensary, Novosibirsk, Russia
Contact: Bergen TA, e-mail:

The article reviews differential diagnosis of sarcomas and leiomyomas of uterine with complex types of degeneration through the case report.

Case report. Differential diagnosis of sarcomas and leiomyomas of uterine using ultrasound and magnetic resonance imaging is discussed in patient Х.

Discussion. For difficulties in interpreting of sonographic image for differential diagnosis of sarcomas and leiomyomas of uterine pelvis MRI is recommended. For MRI with only morphological consequences it is possible to differentiate benign and malignant endometrial tumors only using secondary features such as invasion to adjacent structures, regional lymphadenopaty, presence of metastsases. Contrast enhancing also does not allow to distinguish these lesions decisively because both sarcoma and leiomyoma have heterogenous enhancement. Differential diagnosis for large nodes and sarcomas and leiomyomas of cellular type or mixomatous degeneration is the most difficult.

Conclusion. For difficulties in interpreting of sonographic image for differential diagnosis of sarcomas and leiomyomas of uterine DW pelvis MRI is recommended because according to literature data apparent diffusion coefficient in leiomyoma accounted for 1.3-1.7×10-3 mm2/sec, and in sarcomas this coefficient is rarely higher than 1.1×10-3 mm2/sec.

KEY WORDS: uterine sarcoma, uterine myoma, ultrasound diagnosis, magneric resonance imaging, diffuse-weighted image.

References

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