Dynamic contrast-enhanced MR and PET/CT findings of uterine sarcomatoid carcinoma: a case report
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CASE REPORT
Open Access
Dynamic contrast-enhanced MR and PET/ CT findings of uterine sarcomatoid carcinoma: a case report Tingting Cui, Yanfang Jin, Bin Li, Jiyuan Li and Yunlong Yue*
Abstract Background: Sarcomatoid carcinoma (SC) is a malignant tumour composed of spindle cells. The incidence of SC is low, especially in the uterus. The imaging features of uterine sarcomatoid carcinoma (USC) are rarely reported. We report a case of USC and discuss the dynamic contrast-enhanced MR (DCE-MR) and PET/CT findings. Case presentation: A 69-year-old woman presented to the Department of Gynaecology with vaginal bleeding. Ultrasound examination discovered a heterogeneous mass in the cervix. Then, MRI examination of the pelvis was performed. On T2-weighted images, the uterus was replaced by an ill defined and diffuse lesion with inhomogeneous intensity. On T1-weighted images, the lesion appeared with signal hypointensity and was heterogeneously enhanced with contrast material. Additionally, enlarged lymph nodes were found in the pelvic cavity. PET/CT demonstrated high uptake in the region of the uterus and pelvic lymph nodes, which was consistent with MRI findings. The radiologists diagnosed the patient with malignant uterine lesions. The patient underwent hysterectomy and bilateral adnexectomy with pelvic lymph node dissection. Then, systemic radiotherapy and chemotherapy were performed. USC with lymph node metastasis was diagnosed with the help of immunohistochemical analysis. There was no treatment related complication and no evidence of tumour recurrence at the postoperative 6-month follow-up. Conclusion: MRI and PET/CT features are sufficient to indicate the malignant nature of a USC, but they are not pathognomonic. Keywords: Uterus, Sarcomatoid carcinoma, MRI, PET-CT
Background SC is a rare spindle cell carcinoma [1, 2]. It is most commonly found in the lung, followed by the liver, kidney, bladder and gastrointestinal tract [3, 4]. Clinically, SC is an aggressive malignancy with a high rate of metastasis. It responds poorly to treatment and has a poor prognosis (5-year survival rate of 15–42%) [1, 5]. To date, 18 cases of sarcomatoid squamous cell carcinoma of the cervix have been described in the * Correspondence: [email protected] Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
English-language literature. However, only two reports have discussed the MRI or PET features of USC. Here, we present a case of pathologically confirmed USC and the accompanying DCE-MRI and PET/CT findings.
Case presentation A 69-year-old woman with a past medical history of hypertension, tuberculosis, and meningioma presented with abnormal vaginal bleeding for 10 days as well as fever. Furthermore, her family history was unremarkable. Physical examination revealed a barrel-shaped uterus. The patient felt mild tenderness upon palpation.
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, di
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