Myxoid Leiomyosarcoma of the Uterus: A Case Report With Magnetic Resonance Imaging Findings

Abstract

Myxoid leiomyosarcoma (M-LMS) of the uterus is extremely rare and its diagnosis is challenging. We report a case of the M-LMS in a 69-year-old female who referred to our hospital for abdominal discomfort and increased uterine mass lesion. Magnetic resonance imaging (MRI) demonstrated a well-defined intramural mass (approximately 8 cm in diameter) that exhibited isointensity to myometrium on T1-weighted images, and markedly high heterogeneous intensity and flow-void area suggestive of abundant blood flow on T2-weighted images. On diffusion weighted imaging, the major portion the mass showed high intensity, but it was considered to be T2 shine-through effect, because the mean apparent diffusion coefficient (ADC) value of the lesion was relatively high. Thus, we could not make the diagnosis of malignancy. However, considering the increase tendency of the mass at the postmenopausal status, the possibility of malignancy could not be ruled out, so a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The result of pathologic assessment is M-LMS. A diagnosis of M-LMS is difficult preoperatively. In the case that myxoid tumor is suspected, although malignancy is not definite, we might have to consider the possibility of malignancy from the age of the patient and the tendency of the lesion to increase. J Clin Gynecol Obstet. 2021;10(1):18-21 doi: https://doi.org/10.14740/jcgo675