Abstracts

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E2300. Uterine Sarcomas: Review of Imaging and Management
Authors
  1. Sagar Naik; The University of Texas MD Anderson Cancer Center
  2. Revathy Iyer; The University of Texas MD Anderson Cancer Center
  3. Priya Bhosale; The University of Texas MD Anderson Cancer Center
  4. Preetha Ramalingam; The University of Texas MD Anderson Cancer Center
  5. Dhakshinamoorthy Ganeshan; The University of Texas MD Anderson Cancer Center
Background
Uterine sarcomas are a heterogeneous group of tumors that account for 3%-7% of all uterine cancers. They are of mesenchymal origin, comprising leiomyosarcoma, atypical smooth muscle tumors (STUMP), endometrial stromal sarcoma, and adenosarcoma. Historically carcinosarcomas (malignant mixed mesodermal tumors) were also included but recently they have been reclassified as a dedifferentiated or metaplastic form of endometrial cacrcinoma. Uterine sarcomas demonstrate distinct clinical and biological behavior compared to endometrial carcinoma, and are typically associated with more aggressive behavior and poorer prognosis. Clinical features are often non-specific. Imaging plays an important role in early diagnosis and differentiation from common leiomyomas and endometrial carcinomas, and consequently, in determination of appropriate management. The purpose of this educational exhibit is to describe the imaging spectrum and management of uterine sarcomas.

Educational Goals / Teaching Points
To describe the incidence, histopathological features, and staging of uterine sarcomas. To describe the typical and atypical imaging features of the subtypes and methods of differentiating from common leiomyomas and endometrial carcinomas. To describe the current management of uterine sarcomas.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
MRI and CT are the mainstay in the diagnosis, staging and surveillance of uterine sarcomas. We will discuss the imaging protocol for evaluation of uterine sarcomas. Uterine sarcomas are of stromal/mesenchymal origin compared to endometrial carcinomas which are of epithelial origin. Irregular or nodular margins, intense contrast enhancement and diffusion restriction are some features that can be used to differentiate from other entities. Imaging features unique to the subtypes will be discussed in this exhibit.

Conclusion
Imaging plays a very important role in the detection, characterization and staging uterine sarcomas. Since these tumors are highly aggressive with poorer prognosis, radiologists should be aware of the imaging features that will aid early detection and differentiation from common leiomyomas and endometrial carcinomas.