Uterine sarcomas versus leiomyomas: Gray-scale and Doppler sonographic findings

Purpose. The aim of the study was to evaluate the contribution of gray-scale sonography and Doppler flow studies in differentiating between uterine sarcomas of different histologic types and leiomyomas. Patients and Methods. The study included 111 patients, divided retrospectively into 2 groups: 98 patients with leiomyomas and 13 with postoperative diagnosis of uterine sarcoma. This latter group was further divided into a group of 6 patients with uterine leiomyosarcoma and 7 with malignant mixed mesodermal tumor. The gray-scale sonograms and Doppler parameters in the 3 groups were compared. Results. The patients with leiomyomas were younger than those with sarcomas (52 years ± 11 versus 65 years ± 15, p < 0.05). No differences were noted between the 3 groups regarding gravidity, parity, symptoms upon admission, or findings during physical examination. The sonographic appearances of the leiomyomas were similar to those of the leiomyosarcomas, but in 6/7 cases, they were different from those of the malignant mixed mesodermal tumors. There was a significant difference between the mean resistance index in arterioles of the leiomyomas (0.59 ± 0.01) and that of the malignant mixed mesodermal tumors (0.41 ± 0.06) (P < 0.001) but not between those of the leiomyomas and the leiomyosarcomas (0.49 ± 0.18). Conclusions. Doppler flow studies may assist in differentiating between leiomyomas and malignant mixed mesodermal tumors but not between leiomyomas and leiomyosarcomas.