Korean J Radiol.  2006 Dec;7(4):281-286. 10.3348/kjr.2006.7.4.281.

Sonographic Findings of Uterine Endometrial Stromal Sarcoma

• Kim JA
• Lee MS
• Choi JS

• KMID: 1092552
• DOI: http://doi.org/10.3348/kjr.2006.7.4.281

Abstract

OBJECTIVE
The study was performed to present the sonographic findings of uterine endometrial stromal sarcoma (ESS). MATERIALS AND METHODS: We conducted a retrospective review of sonographic findings of 10 cases that were diagnosed as uterine ESS. The patients' ages ranged from 25 to 51 years (mean age: 36.1 years). The reviews focused on the location, margin, size, number and echotexture of the lesions. Hysterectomy (n = 9) and myomectomy (n = 1) were performed and a pathologic diagnosis was obtained in all cases. RESULTS: The masses were located in the uterine wall (n = 6), or they presented as a polypoid mass protruding into the endometrial cavity from the myometrium (n = 3) or as a central cavity mass (n = 1). The lesion margins were smooth (n = 5), ill defined (n = 2), or smooth with partially nodular extensions (n = 3). The maximal mass length was 38 mm to 160 mm with a mean mass length of 83.5 mm. There were single lesions in eight cases and multiple lesions in two cases. The lesion echotextures were hypoechoic solid (n = 3), heterogeneously intermediate echoic (n = 5), diffuse myometrial thickening with heterogeneous echogenicity (n = 1) and septated cystic (n = 1). CONCLUSION: Endometrial stromal sarcoma presents with four patterns of its sonographic appearance; a polypoid mass with nodular myometrial extension, an intramural mass with an ill defined margin and heterogeneous echogenicity, an ill defined large central cavity mass or, diffuse myometrial thickening.

Keyword

Ultrasound (US); Uterine sarcoma; Endometrial stromal sarcoma

MeSH Terms

Ultrasonography, Doppler, Color
Sarcoma, Endometrial Stromal/pathology/*ultrasonography
Retrospective Studies
Middle Aged
Humans
Female
Adult

Figure

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  Fig. 1 Sonographic findings of endometrial stromal sarcoma that presented as a mural mass in patient 2.A heterogeneously echoic mass with an ill defined margin is noted in the uterine wall (thick arrows). The endometrium is displaced by the mass (thin arrows). Color Doppler sonography demonstrates a focally dispersed vascularity within the mass.Pathology revealed a subendometrial endometrial stromal sarcoma invading more than half of the myometrial thickness (not shown).

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  Fig. 2 Sonographic findings of endometrial stromal sarcoma, which presented as a polypoid mass protruding into the endometrial cavity from the myometrium in patient 1.

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  Fig. 3 Endometrial stromal sarcoma that presented as a huge central cavity mass.An ill defined, septated cystic mass with a solid portion is noted in the uterine central cavity in patient 9. The endometrium is obliterated by the mass and myometrial thinning is noted (arrow).Pathology revealed a low grade endometrial stromal sarcoma invading the endometrium and almost the full thickness of the anterior myometrium and cystic degeneration of the tumor (not shown).

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  Fig. 4 Endometrial stromal sarcoma that presented with diffuse myometrial thickening.

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