Title: Revisiting Imaging and Pathology of Malignant Appearing Uterine Smooth Muscle Tumors: A Mistaken Identity of Leiomyosarcoma on MRI
Abstract: Uterine leiomyoma is a relatively common condition occurring in a majority of African American and Caucasian women by age 50.Magnetic resonance imaging of the pelvis with contrast is the modality of choice when evaluating uterine tumors.We report a case of a patient with a four-day history of intra-menstrual vaginal bleeding who underwent magnetic resonance imaging of the pelvis that suggested the tumor was a leiomyosarcoma, the malignant counterpart of leiomyoma.Therefore, the patient underwent pre-operative uterine artery embolization to decrease blood loss with exploratory laparotomy, resection of pelvic mass and dilation and curettage.Pathologic evaluation of the mass returned a diagnosis of leiomyoma.Magnetic resonance imaging evaluation of leiomyomata remains difficult.Further development of imaging parameters could improve diagnosis of benign uterine fibroids.