Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule
Preoperative differentiation of benign endometrial stromal nodule (ESN) from malignant low-grade endometrial sarcoma (LGESS) is challenging, because it requires histological evaluation of the tumor-myometrium interface, which is difficult to obtain in conventional endometrial curettage. A 72-year-ol...
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| Format: | Article |
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Wiley
2015-01-01
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| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2015/540283 |
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| author | Shunsuke Maruyama Yukiyasu Sato Yumiko Satake Hiroko Mise Tomoko Kim |
| author_facet | Shunsuke Maruyama Yukiyasu Sato Yumiko Satake Hiroko Mise Tomoko Kim |
| author_sort | Shunsuke Maruyama |
| collection | DOAJ |
| description | Preoperative differentiation of benign endometrial stromal nodule (ESN) from malignant low-grade endometrial sarcoma (LGESS) is challenging, because it requires histological evaluation of the tumor-myometrium interface, which is difficult to obtain in conventional endometrial curettage. A 72-year-old postmenopausal woman presented with 5-year history of persistent vaginal bleeding. Histological examination of the endometrial curettage specimen revealed hyperplasia of apparently normal endometrial stromal cells. T2-weighted magnetic resonance imaging (T2W-MRI) showed polypoid tumor occupying the entire uterine cavity. The tumor exhibited high signal intensity in diffusion-weighted MRI (DW-MRI) and intense accumulation of 18F-fluorodeoxyglucose (FDG) in positron emission tomography (PET). Intense FDG accumulation was also observed in the left internal iliac region. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed under the diagnosis of LGESS with lymph node metastasis. However, postoperative histological examination proved that the tumor was ESN without lymph node metastasis. Since mitotic figure is no longer included in the diagnostic criteria of ESN or LGESS, ESN could exhibit high cellularity and high proliferative activity as observed in this case. Therefore, DW-MRI or FDG-PET is not useful in the differentiation of ESN from LGESS. |
| format | Article |
| id | doaj-art-49a75e013bec4bdd97dac7bd3a350d4f |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
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| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-49a75e013bec4bdd97dac7bd3a350d4f2025-02-03T01:33:12ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922015-01-01201510.1155/2015/540283540283Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal NoduleShunsuke Maruyama0Yukiyasu Sato1Yumiko Satake2Hiroko Mise3Tomoko Kim4Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, JapanDepartment of Obstetrics and Gynecology, Otsu Red Cross Hospital, JapanDepartment of Obstetrics and Gynecology, Otsu Red Cross Hospital, JapanDepartment of Obstetrics and Gynecology, Otsu Red Cross Hospital, JapanDepartment of Obstetrics and Gynecology, Otsu Red Cross Hospital, JapanPreoperative differentiation of benign endometrial stromal nodule (ESN) from malignant low-grade endometrial sarcoma (LGESS) is challenging, because it requires histological evaluation of the tumor-myometrium interface, which is difficult to obtain in conventional endometrial curettage. A 72-year-old postmenopausal woman presented with 5-year history of persistent vaginal bleeding. Histological examination of the endometrial curettage specimen revealed hyperplasia of apparently normal endometrial stromal cells. T2-weighted magnetic resonance imaging (T2W-MRI) showed polypoid tumor occupying the entire uterine cavity. The tumor exhibited high signal intensity in diffusion-weighted MRI (DW-MRI) and intense accumulation of 18F-fluorodeoxyglucose (FDG) in positron emission tomography (PET). Intense FDG accumulation was also observed in the left internal iliac region. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed under the diagnosis of LGESS with lymph node metastasis. However, postoperative histological examination proved that the tumor was ESN without lymph node metastasis. Since mitotic figure is no longer included in the diagnostic criteria of ESN or LGESS, ESN could exhibit high cellularity and high proliferative activity as observed in this case. Therefore, DW-MRI or FDG-PET is not useful in the differentiation of ESN from LGESS.http://dx.doi.org/10.1155/2015/540283 |
| spellingShingle | Shunsuke Maruyama Yukiyasu Sato Yumiko Satake Hiroko Mise Tomoko Kim Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule Case Reports in Obstetrics and Gynecology |
| title | Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule |
| title_full | Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule |
| title_fullStr | Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule |
| title_full_unstemmed | Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule |
| title_short | Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule |
| title_sort | diffusion weighted mri and fdg pet in diagnosis of endometrial stromal nodule |
| url | http://dx.doi.org/10.1155/2015/540283 |
| work_keys_str_mv | AT shunsukemaruyama diffusionweightedmriandfdgpetindiagnosisofendometrialstromalnodule AT yukiyasusato diffusionweightedmriandfdgpetindiagnosisofendometrialstromalnodule AT yumikosatake diffusionweightedmriandfdgpetindiagnosisofendometrialstromalnodule AT hirokomise diffusionweightedmriandfdgpetindiagnosisofendometrialstromalnodule AT tomokokim diffusionweightedmriandfdgpetindiagnosisofendometrialstromalnodule |