Uterine Sarcoma
Synonyms/Description
Many different types of uterine sarcoma, including but not limited to carcinosarcoma, adenosarcoma, leiomyosarcoma, and endometrial stromal sarcoma
Etiology
Uterine sarcomas are rare tumors of mesenchymal origin, representing approximately 5% of all uterine malignancies.
They are classified into three groups according to their source:
1. Mixed epithelial and mesenchymal tumors, which include carcinosarcomas. These were previously termed malignant mixed Müllerian tumors (MMMTs) and adenosarcomas.
2. Smooth muscle tumors, which are leiomyosarcomas
3. Endometrial stromal tumors, which include endometrial stromal sarcoma and high-grade undifferentiated sarcoma
Carcinosarcoma is the most common, accounting for 50% of all uterine sarcomas. It is typically diagnosed in the sixth decade and often presents with postmenopausal bleeding. The presentation and risk factors are similar to endometrial adenocarcinoma. It is an aggressive tumor with extrauterine spread to lymph nodes or beyond found in 30% of patients at initial diagnosis.
Adenosarcoma is a less aggressive tumor than carcinosarcoma. It tends to be smaller and confined to the uterus at presentation and has a more favorable prognosis.
Leiomyosarcoma is the second most common uterine sarcoma, occurs mostly in the fifth decade of life, and accounts for almost 40% of cases. These tumors are not thought to arise from existing myomas. They generally present with the same symptoms attributed to enlarging fibroids and rapid growth of the uterus.
Endometrial stromal sarcomas represent approximately 10% of uterine sarcomas and typically present with vaginal bleeding and pelvic pain in women 40 to 55 years of age.
Ultrasound Findings
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