109 Uterine Sarcomas

Uterine sarcomas constitute 1 to 3% of malignant uterine tumors. The most common sarcomas are mixed mullerian sarcoma (also known as carcinosarcoma), leiomyosarcomas, and endometrial stromal sarcomas. Mixed mullerian tumors (MMT) are the most common (40 to 70%) followed by leiomyosarcoma (40 to 50%). Endometrial stromal sarcomas (ESS) are more rare (10%).1 Low-grade endometrial stromal sarcomas usually are seen in a younger age group (premenopausal) than mixed mullerian sarcomas or high-grade endometrial stromal sarcomas (postmenopausal).^2,3

Imaging features can be helpful in distinguishing the uterine sarcomas from each other as well as from other lesions such as endometrial carcinoma, leiomyoma (see Chapter 108), and adenomyosis.

1. Leiomyosarcomas tend to present as large myometrial masses.
   
2. MMT and ESS present as invasive endometrial masses.¹

Features of Endometrial Stromal Sarcoma

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