Ultrasonography in the staging of endometrial adenocarcinoma

Adenocarcinoma of the endometrium commonly presents at an early stage and is readily diagnosed by dilatation and curettage. Ultrasound has not bee accurate in differentiating this malignant neoplasm from benign causes of uterine enlargement such as leiomyoma. In this study, the sonographic findings in 21 patients with adenocarcinoma of the endometrium were compared with the clinical and pathological findings. Although no ultrasound criteria were diagnostic of carcinoma, there were statistically significant differences in uterine shape and echo pattern between Stage I-II and Stage III-IV disease: 94% of patients with Stage I-II disease had a normal or bulbous uterus and a normal or hypoechoic parenchymal pattern, while patients with a lobular uterus and/or mixed echo pattern had Stage III-IV. The only clinical errors in staging were in cases of Stage II or III disease. Ultrasound may be helpful in pretreatment staging of more difficult cases.