超声误诊子宫平滑肌肉瘤为子宫肌瘤：病例报告与文献回顾kvj3p.doc

超声误诊子宫平滑肌肉瘤为子宫肌瘤：病例报告与文献回顾 Uterine leiomyosarcoma misdiagnosis as leiomyomatosis bysonography case reports and review of the literatureHUANG Ying Liu Da JIANG Luo51015202530354045 Shengjing hospital of China Medical University ShenYang 110004 Abstract Objective-- Leiomyosarcoma is one of the three most common histological variants ofuterine sarcoma A high index of suspicion is needed in the diagnosis of this rare but highly fatal tumorThe aim of this retrospective study was to discuss the misdiagnosis of sonography in distinguishing LMfrom LMS and to describe the rare sonographic features of LMS Materials and Methods-- All patientshad undergone transvaginal and or transabdominal ultrasound examination before histopathologicalexamination We analyzed the preoperative gray-scale and color Doppler sonographic findings of 2patients Number size echotexture degenerative changes and vascularity central or peripheral absentmild moderate or marked were recorded All patients underwent laparotomy Results--They werefound to have uterine malignancies and these were confirmed to be leiomyosarcoma after pathologicexamination About our 2 cases one without degenerative cystic changes and the other withcalcification which were not consistent with a majority of LMSs sonography In addition thevascularity showed in the whole mass had not a marked increase ConclusionsThe findings of thepresent study suggest that when uncharacteristic sonography of LMSs were observed more effortshould be directed at ruling out uterine sarcoma in all patients with presumptive diagnosis ofleiomyoma more especially if they are postmenopausalKeywords leiomyomasacroma leiomyomatosis sonography0 INTRODUCTIONLeiomyosarcoma LMS represents about 13 of uterine malignancies and about one-thirdof uterine sarcomas [1] The prognosis of uterine sarcoma is worse compared with commonendometrial cancer and its clinical behaviour tends to be more aggressive with earlylymphovascular spreading The