EP18.10: Uterine sarcoma: clinical presentation and sonographic findings

Abstract

To describe the common sonographic characteristics of sarcoma cases and the differences between them. Cases of patient with histologic diagnosis of uterine sarcoma during the years 2012-2018 were evaluated. Medical records, including medical history, histology, sonographic assessment and surgical findings were assessed. During the relevant time period, 6 patients were diagnosed with uterine sarcoma. Their age at diagnosis ranged between 38 to 68 years. All but one patient were either postmenopausal or peri-menopausal. 5 of the 6 cases had a presenting symptom of abnormal uterine bleeding. Histology results included leiomyosarcoma (4/6), carcinosarcoma (1/6) and endometrial stromal sarcoma (1/6). Only 3 cases (50%) where considered to have high risk for sarcoma prior to surgery. 3 cases had a uterine mass with clear margins and heterogeneous echogenicity within the mass. 2 cases had a diffusely spread mass in the uterus, one of them with lateral spread of the tumour mass to the pelvis. 1 case had an anechoic liquid myometrial mass with clear margins. Doppler examination was done in 4 of 6 cases and 2 cases had hypervascularisation. 5 cases did not have any acoustic shadowing within the mass. Leiomyosarcoma, and uterine sarcoma in general, have a very variable sonographic appearance. In most of our cases no acoustic shadowing was seen in the masses. Since acoustic shadowing is a common finding in large fibroids it is suggested that absence of shadowing in a myometrial mass should raise suspicion of sarcoma Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.