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Magnetic resonance imaging findings in 11 cases of dedifferentiated endometrial carcinoma of the uterus

Authors
  • Kikkawa, Nao1
  • Ito, Kimiteru1
  • Yoshida, Hiroshi2
  • Kato, Mayumi Kobayashi2
  • Kubo, Yuko1
  • Onishi, Yasuyuki1
  • Sugawara, Haruto1
  • Kato, Tomoyasu2
  • Kusumoto, Masahiko1
  • 1 National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 1040045, Japan , Tokyo (Japan)
  • 2 National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan , Tokyo (Japan)
Type
Published Article
Journal
Japanese Journal of Radiology
Publisher
Springer Singapore
Publication Date
Jan 30, 2021
Volume
39
Issue
5
Pages
477–486
Identifiers
DOI: 10.1007/s11604-020-01084-3
Source
Springer Nature
Keywords
License
Green

Abstract

PurposeWe evaluated magnetic resonance imaging (MRI) findings of dedifferentiated endometrial carcinoma (DEC), comprising undifferentiated carcinoma and low-grade endometrioid carcinoma.Materials and methodsWe recruited 11 patients with pathologically proven DEC treated at our institute. We evaluated primary lesion size, location and signal intensity on MRI, and prognosis. MRI and pathological findings were compared in eight resected patients.ResultsPrimary tumors ranged from 16 to 206 mm in diameter. DEC was located at the endometrium in 9 of the 11 patients; the remaining two patients showed diffuse involvement of the enlarged myometrium. These two patients with diffuse involvement type died within 4 months. Of the eight patients who underwent resection, seven had macroscopic intratumoral hemorrhage and six showed a high signal on T1-weighted images or low signal on T2-weighted images. Of the eight resected patients, four had tumor necrosis > 25% and tumor size > 5 cm. In these patients, necrosis appeared as nonenhanced areas on contrast-enhanced MRI.ConclusionMRI findings of DEC showed two patterns: mass-forming type and diffuse myometrial type with poor prognosis. Most patients with DEC had intratumoral hemorrhage, and large tumors (> 5 cm) had gross necrosis, which appeared as nonenhanced areas on contrast-enhanced MRI.

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