Endometrial stromal tumors, their varied radiographic patterns

Area of Science:

• Gynecologic Pathology
• Radiology
• Oncology

Background:

• Endometrial stromal neoplasms (ESNs) represent a spectrum from benign to low-grade malignant tumors.
• These neoplasms have a propensity for metastasis, necessitating accurate diagnosis.
• Despite metastatic potential, ESNs offer an excellent prognosis with timely and aggressive management.

Observation:

• This study presents the radiographic spectrum of ESNs in seven patients.
• Patients typically present with vaginal bleeding, and often diarrhea, in middle age.
• Previous uterine surgery, even for benign conditions like fibroids, warrants suspicion.

Findings:

• Radiographic imaging revealed pelvic masses on plain films, IVP, and BE.
• Ultrasound demonstrated mixed cystic features, while CT scans showed solid masses.
• ESNs can mimic colon carcinoma, retroperitoneal tumors, and pelvic inflammatory disease, with lung and bone metastases identified.

Implications:

• Early and accurate diagnosis of ESNs is crucial for effective treatment and long-term survival.
• Radiographic findings, particularly CT and ultrasound, aid in differentiating ESNs from other pelvic pathologies.
• Awareness of the varied presentations and metastatic patterns of ESNs is essential for clinicians.