EP29.15: Uterine sarcomas: clinical presentation and imaging features

To present the pelvic ultrasound aspects and their contribution in the diagnostic approach of the uterine sarcomas. To expose the correlation between pelvic ultrasound, MRI and the definitive anatomopathological results. It is a retrospective study of 8 cases of uterine sarcomas taken care during the last 5 years (2012-2016). We reviewed all cases confirmed by anatomopathological examination and studied the clinical symptoms. we analysed the pelvic ultrasound aspects, the contribution of MRI and studied the correlation between imaging and the definitive anatomopathological result for each case. The average age of patients was of 54 years. 5 patients were menopausal at the time of the diagnosis. Bleeding was the most found symptom (5 cases/8). Pelvic ultrasound was performed in all case. Sarcomas presented either as an echogenic heterogeneous mass (n=6) or as a solid or cystic mass (n=2).The malignancy was suspected in a single case. MRI was performed in only three cases. The contribution of this exam was limited, Conclusions of the first two examinations were reassuring by evoking reshaped myomas. Concerning the last patient, the heterogenous character on the various MRI sequences allowed to suspect a malignant mass. After surgery, the distribution according to the histopathologic type was established as follows: léiomyosarcoma (n=3); Carcinosarcoma (n=2); endometrial stromal sarcoma (n=2) and undifferentiated sarcoma (n=1). The preoperative diagnosis of uterine sarcomas is not easy. Imaging aspects are not specific. Pelvic ultrasound and MRI are important to precise the mapping of myometrial tumours. The final diagnosis rely on the histopathologic examination after surgery.