Assessing the Clinical Characteristics and the Role of Imaging Modalities in Uterine Sarcoma: A Single-Center Retrospective Study From Vietnam.

Abstract

Background: This study aims to describe the clinical and imaging characteristics of uterine sarcomas and the role of imaging modalities in assessing them.

Materials and methods: This retrospective study enrolled all patients diagnosed with uterine sarcoma at Tu Du Hospital, Vietnam between January 2020 and December 2023. The findings of ultrasound (US) and magnetic resonance imaging (MRI) were compared to histology as the reference.

Results: Among 78 patients, 46.2% of cases were menopause. Abnormal vaginal bleeding was the most common symptom. Three common types of uterine sarcoma were leiomyosarcoma (50.0%), low-grade endometrial stromal sarcoma (23.1%), and carcinosarcoma (19.2%). Some imaging features of uterine sarcomas were found including nontypical lesion of fibroid (89.7%), solitary mass (84.6%), inhomogeneous structure (76.9%), invisible endometrium (67.9%), moderate-rich vascularization on Doppler signal (57.7%), irregular border of tumor (48.7%), classification of FIGO 0 (44.9%), cystic area within tumor (42.3%), acoustic shadowing (34.6%), "cooked" appearance (9.0%), and calcification image in tumor (6.4%). The sensitivity of standard US, consultant US, and MRI was 56.4%, 88.4%, and 87.5%, respectively.

Conclusions: Besides clinical presentations, uterine sarcomas present some specific features on US. Consultant US and MRI could be added to standard US to increase the accuracy and help in surgical decision making where applicable.