低度恶性子宫内膜间质肉瘤的MR I诊断

目的：探讨低度恶性子宫内膜间质肉瘤(LGESS)的 MRI特点,提高对其诊断的准确性。方法回顾性分析经手术病理证实的4例LGESS病例的临床及MRI资料。全部病例均行MRI平扫。结果4例均表现为子宫不同程度的增大。病变直径5~12.1 cm,平均9 cm。3例位于宫腔内并累及子宫肌层,呈实性,结合带中断或消失,其中1例侵及膀胱、右侧输尿管、右侧输卵管及右侧卵巢;1例位于子宫肌层内,呈囊性,可见分隔和清晰的边界。3例实性肿瘤 MRI平扫表现为 T1 WI等信号,T2 WI稍高信号,1例信号欠均匀,其内及边缘可见增粗流空血管影;1例囊性肿瘤 MRI平扫表现为 T1 WI低信号,T2 WI高信号,内分隔呈低信号。3例合并子宫肌瘤,1例伴盆腔淋巴结转移。结论子宫内膜间质肉瘤好发于宫腔内,少数发生于子宫肌层,肿瘤多呈实性,也可呈囊性,多向子宫肌层浸润生长,肿瘤于T1 WI呈等或低信号,T2 WI呈高信号,信号可不均匀,其在 MRI 上有一定的特点,能为该病的正确诊断提供帮助。     

MR imaging findings of uterine endometrial stromal sarcoma: differentiation from endometrial carcinoma

Endometrial stromal sarcoma (ESS) is a rare malignant neoplasm of the uterus. We retrospectively analyzed pelvic MR imaging in 8 cases of ESS to determine the characteristic MR findings of ESS. Magnetic resonance images of 8 cases of ESS were evaluated for findings including the size, margin of the tumor, nodular lesions at the tumor margin, intramyometrial worm-like nodular extension, multiple nodular mass formation, hemorrhage, and necrosis in the tumor. The degree of contrast enhancement was also analyzed. The MR imaging findings of 21 consecutive cases of endometrial carcinoma (EC) were also evaluated and compared with those of ESS. The mean and the standard deviation of the maximum diameter of ESS and EC were 8.80 ± 4.99 and 3.93 ± 2.47 cm, respectively. Increased enhancement in at least a part of the tumor was observed in five of the six analyzed ESS cases and in 2 of 12 analyzed EC cases. The irregular margin, nodular lesions at the margin, intramyometrial nodular extension, and multiple nodular mass formation were more frequently seen in cases of ESS than in cases of EC. Magnetic resonance imaging can play a role in both diagnosing ESS as well as in differentiating ESS from EC. Received: 17 December 1999 Revised: 18 May 2000 Accepted: 22 May 2000     

Uterine endometrial stromal sarcoma located in uterine myometrium: MRI appearance

Two cases of uterine endometrial stromal sarcoma whose main mass was located in uterine myometrium are reported. They mimicked uterine leiomyoma with cystic degeneration or uterine leiomyosarcoma. Endometrial stromal sarcoma should be suggested in the differential diagnosis of mass lesion in uterine myometrium. Received: 9 March 1999; Revised: 2 September 1999; Accepted: 25 November 1999     

子宫内膜间质肉瘤的MRI表现

目的 分析子宫内膜间质肉瘤(ESS)的MRI表现特点,探讨MRI在其临床应用中的价值.方法 收集本院经手术病理证实的ESS 13例,术前均行MRI平扫及扩散加权成像(DWI)扫描,其中10例同时行增强扫描,结合手术后病理结果分析其MRI表现.结果 13例病例中,位于宫腔6例、子宫肌层4例、子宫右侧壁及阔韧带1例、宫颈1例、阴道顶端及盆腔内1例.在MRI平扫上表现为突向宫腔或位于肌层的息肉状或多发结节状肿块,呈长T1长T2信号,在DWI序列上均表现不同程度的高信号,10例增强扫描后实性部分中度至明显不均匀强化,时间-信号强度曲线6例呈平台型,4例呈持续上升型.结论 ESS的MRI表现具有一定的特征性,DWI及动态增强检查有助于本病的诊断及鉴别诊断.     

Acute Lymphoblastic Leukemia Presented as Multiple Breast Masses

Breast metastases in cases leukemia are very rare and occur primarily in patients with acute myeloid leukemia. We report the involvement of breast metastases in a 30-year-old woman with acute T cell lymphoblastic leukemia. The patient''s mammograms revealed an extremely dense pattern with ill-defined, denser mass-like lesions in both breasts. A bilateral breast ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a multi-septated nodular (mottled) appearance.     

CT,MRI, and FDG-PET imaging findings of low-grade extrauterine endometrial stromal sarcoma arising from the mesentery: A case report

Endometrial stromal sarcoma is a rare uterine mesenchymal neoplasm, and extrauterine endometrial stromal sarcoma is even rarer, with a limited number of case reports. In the present report, we present a case of low-grade extrauterine endometrial stromal sarcoma originating from the mesentery in a 49-year-old woman, without endometrial stromal sarcoma in the uterus or evidence of endometriosis. The tumor was diagnosed using recombination of the JAZF1 gene by fluorescence in situ hybridization. Computed tomography, magnetic resonance imaging, and 18F-fluorodeoxyglucose positron emission tomography/computed tomography showed a 13 cm, primarily polycystic, mass containing a contrast-enhancing solid component with restricted diffusion and mild 18F-fluorodeoxyglucose uptake. A large cystic component may be a characteristic feature of extrauterine endometrial stromal sarcoma, given the low pressure from the surrounding tissues.     

Endometrial stromal sarcoma of the uterus: MR and US findings

We describe the MRI and US features of two patients with endometrial stromal sarcoma of the uterus. Both lesions appeared as voluminous polypoid masses within an expanded endometrial cavity on both US and MRI. They had mixed echotexture and heterogenous signal intensity on both T1- and T2-weighted sequences. T2-weighted images were most helpful in detecting the endometrial nature of the disease and its relationships with surrounding myometrium. Received: 29 March 1999; Revised: 10 August 1999; Accepted: 11 August 1999     

Endometrial stromal sarcoma located in the myometrium with a low‐intensity rim on T2‐weighted images: Report of three cases and literature review

Endometrial stromal sarcoma (ESS) most commonly grows from the uterine endometrium into the endometrial cavity; it is rarely located in the myometrium alone, where it may resemble degenerated leiomyoma on magnetic resonance imaging (MRI). We present three cases of intramyometrial ESS mimicking degenerated leiomyoma, all of which have a characteristic low‐intensity rim on T2‐weighted images. Histopathological examination revealed the rim to consist of fibrous tissue layers and/or a decrease in free water caused by distortion of myometrial tissue following tumor expansion. ESS should be included in the differential diagnosis of intramyometrial mass with low‐intensity rim on T2‐weighted image, especially if the mass shows degeneration with no or mild intratumoral hemorrhage. J. Magn. Reson. Imaging 2010;31:975–979. ©2010 Wiley‐Liss, Inc.     

Metastasis to the breast from extramammary malignancies: a report of four cases and a review of literature

Breast metastases from extramammary tumours are rare with few cases reported. Four cases of metastasis to the breast are presented and the diagnostic problems of this condition are reviewed. Correlation between the histology of primary tumour and the cytology of breast metastatic tumour can avoid the surgical breast biopsy and unnecessary mastectomy. Metastasis to the breast has poor prognosis.     

Alveolar soft part sarcoma in a young woman: A case report from Hong Kong

Alveolar soft part sarcoma (ASPS) is a rare, highly vascular, deep soft tissue mesenchymal malignancy that is classically seen in the lower extremities of young adults. We reported a case of a 32-year-old young Chinese woman in Hong Kong with a biopsy-proven alveolar soft part sarcoma. The condition can be suggested by classical features using contrast-enhanced CT scans and MRIs or confirmed by image-guided biopsies. Early recognition of the condition is important due to its poor prognosis and lack of awareness. The mainstay of treatment for ASPS is complete surgical resection of the primary tumor and radiotherapy for microscopic residual disease at the primary site, or chemotherapy in special cases.     

Efficacy and safety of CT-guided 125I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma after surgery and external beam radiotherapy: A 12-year study at a single institution

ObjectivesThe objective of this study was to evaluate the efficacy and safety of CT-guided radioactive ¹²⁵I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma (HNSTS) after surgery and external beam radiotherapy.Methods and MaterialsFrom December 2006 to February 2018, 25 patients with locally recurrent HNSTS after surgery and external beam radiotherapy were enrolled. All the patients successfully underwent CT-guided ¹²⁵I seed implantation. The primary end points included the objective response rate (ORR) and local progression-free survival (LPFS). The secondary end points were survival (OS) and safety profiles.ResultsAfter ¹²⁵I seed implantation, the ORR was 76.0%. The 1-, 3-, and 5-year LPFS rates were 65.6%, 34.4%, and 22.9%, respectively, with the median LPFS of 16.0 months. The 1-, 3-, and 5-year OS rates were 70.8%, 46.6%, and 34.0%, respectively, with the median OS of 28.0 months. Furthermore, univariate analyses showed that the recurrent T stage and histological grade were prognostic factors of LPFS, whereas only the histological grade was a predictor of OS. The major adverse events were skin/mucosal toxicities, which were generally of lower grade (≤Grade 2) and were well tolerated.ConclusionsRadioactive ¹²⁵I seed implantation could be an effective and safe alternative treatment for locally recurrent HNSTS after failure of surgery and radiotherapy. Recurrent T stage and histological grade were the main factors influencing the efficacy.     

Long-term oncological follow-up after mold-based pulsed dose rate brachytherapy for early stage squamous cell carcinoma of the nasal vestibule: A single center experience of 68 patients over a 17-year period

PURPOSECancer of the nasal vestibule is a rare type of malignancy constituting less than one percent of all head and neck cancers. These tumors are typically diagnosed at an early stage. Both surgery and radiotherapy provide excellent oncological results, but esthetic results are better after radiotherapy. The aim of this study was to evaluate the long-term oncological follow-up after brachytherapy for early stage squamous cell carcinoma of the nasal vestibule.METHODS AND MATERIALSRetrospective analysis of patients with carcinoma of the nasal vestibule who were treated with primary brachytherapy in the Utrecht University Medical Center.RESULTSIn this single center experience over a 17-year period 68 patients with early stage squamous cell carcinoma of the nasal vestibule were treated with brachytherapy. Two patients had lymph node metastases at first clinical presentation. Median follow-up duration was 46.5 months. Five-year locoregional recurrence-free survival, disease-specific survival, and overall survival were 91.1%, 96.1%, and 66.2%, respectively. All recurrences occurred within the first 3 years of follow-up.CONCLUSIONSBrachytherapy offers excellent oncological outcomes and is a safe and effective treatment for early stage carcinoma of the nasal vestibule. Recurrences typically occur within 3 years after treatment.