Gynecologic - Oncology Division, Department of Obstetrics and Gynecology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
J Ultrasound Med. 2022 Jul;41(7):1837-1844. doi: 10.1002/jum.15855. Epub 2021 Nov 2.
Uterine leiomyosarcoma is a rare malignancy and is difficult to diagnose preoperatively. In this case series, we retrospectively reassessed ultrasound findings of 18 leiomyosarcoma cases and proposed the diagnostic workup. We are select seven ultrasound features and found irregular tumor border in 100%, loss of normal myometrium >25% in 61.11% (12 cases), loss of typical benign leiomyoma feature >50% in 77.78%, necrosis in 85.7% (16 cases), and cystic degeneration in 83.3% (15 cases). Circumferential vascularity was absent or minimal in 66.7% of cases, whereas intralesional vascularity with minimal or moderate intralesional vascularity was seen in 12 (66.7%) cases. Diagnosis of suspected uterine leiomyosarcoma requires five out of these seven features present, four gray-scale and one color Doppler ultrasound.
子宫平滑肌肉瘤是一种罕见的恶性肿瘤，术前难以诊断。在本病例系列中，我们回顾性重新评估了 18 例平滑肌肉瘤的超声表现并提出了诊断方法。我们选择了 7 个超声特征，发现 100%的肿瘤边界不规则，61.11%（12 例）正常子宫肌层缺失>25%，77.78%典型良性平滑肌瘤特征缺失>50%，85.7%（16 例）坏死，83.3%（15 例）囊性变性。66.7%的病例无或极少环绕血流，12 例（66.7%）有病灶内血流，为少量或中等量。疑似子宫平滑肌肉瘤的诊断需要 7 个特征中的 5 个呈现，4 个灰阶超声特征和 1 个彩色多普勒超声特征。
