UTROSCT: a case report and scoping review of ultrasound features, with exploratory serum proteomic findings

UTROSCT is a rare uterine neoplasm with nonspecific imaging features. The aim of this study was to evaluate how UTROSCT is described on pelvic and transvaginal ultrasound in the published case-report literature and to report the clinicopathologic, immunophenotypic, and exploratory serum proteomic features of a new UTROSCT case.

Transvaginal ultrasound revealed an intracavitary uterine lesion in a 72-year-old asymptomatic postmenopausal woman. Histopathology and immunohistochemistry on biopsy and hysterectomy specimens supported the diagnosis of group II UTROSCT with no myometrial invasion and no lymph node involvement. Exploratory serum proteomic analysis, performed as a hypothesis-generating approach, suggested enrichment of extracellular matrix-related proteins compared with a healthy control and an endometrial stromal sarcoma control.

We searched MEDLINE (PubMed), Scopus, and Google Scholar from January 2004 to December 2025 to identify English-language case reports of histologically confirmed UTROSCT that included at least one pelvic/transvaginal ultrasonographic assessment. Records were screened independently by two reviewers. The review was conducted and reported according to PRISMA ScR. Data were charted using a predefined form capturing age and ultrasound presentation categories (e.g., fibroid-like, polyp-like, pelvic mass/unspecified). Reporting quality was appraised using the JBI Critical Appraisal Checklist for Case Reports; appraisal results were not used for exclusion.

Out of 359 case reports identified, only 99 were included in the evidence mapping. The mean age of the examined population is 49.2 years. The results of our review showed that UTROSCT presents as a fibroid in the majority of cases (46.5%).

Diagnosis of UTROSCTs could be challenging because it is a rare condition. The ultrasound appearance is heterogeneous and often not accurately reported in literature. Our review shows that UTROSCT most frequently mimics leiomyoma at ultrasound. In our case report, exploratory serum proteomics may generate hypotheses for future translational research but requires tissue-level validation.