Imagerie des sarcomes utérins

Uterine sarcomas constitute less than 4% of all uterine neoplasms. The most common histological variants are leiomyosarcoma, carcinosarcoma and endometrial stromal sarcoma. The treatment associates surgery and radiotherapy; an adjuvant chemotherapy is proposed in forms of high rank. Prognosis is dark and depends on tumour extent at diagnosis and on quality of the initial surgery. The diagnosis is often post-surgical, and the sarcoma account represents 0.2 to 1% of the lesions operated with the preoperative diagnosis of uterine leiomyomas. Doppler ultrasound cannot differentiate the uterine sarcomas from myomas. MRI and DCE-MRI are useful by showing high post-contrast intensity signal (higher than myometrium) and necrosis. In case of preserving surgical treatment of uterine myomas, it seems licit to propose MRI in order to avoid an intra-abdominal parcelling out of a uterine sarcoma, taking into account the gravity of prognosis in this case.