Uterine sarcoma is a rare neoplasm, accounting for only 5% of uterine malignancies. The pathogenesis of uterine sarcoma remains largely unknown, although recent basic science and pre-clinical animal models have provided a better understanding of tumor biology. The aim of this study was to review the clinical features, imaging characteristics, genetic aberrations and therapeutic approaches in uterine sarcoma. This study reviewed the English-language literature on clinical and basic studies on uterine sarcoma. The common variants of uterine sarcoma are carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma (ESS). Genetic profiling efforts have identified amplification, overexpression and mutation, while the molecular mechanisms of tumorigenesis driven by these genomic and genetic aberrations have yet to be fully elucidated yet. Recent genome-wide studies have also identified complex chromosomal rearrangements as oncogenic mechanisms. The cell cycle regulators, p16 and p53, are frequently over-expressed and appear to be involved in key modifications of sarcomagenesis. Molecular-targeted therapy has now been evaluated in clinical trials for certain subtypes. In conclusion, aberrations of cell cycle control would be a critical step in the development of uterine sarcoma. This review has provided new areas of study targeting molecular and genetic pathways.

/pdf/the-biology-of-uterine-sarcomas-a-review-and-update-1wfm2yzq7x.pdf

The biology of uterine sarcomas: A review and update.

Recent advances in genetics and pathology have improved our understanding of diagnosis and staging of uterine sarcomas. The major types of uterine sarcomas include leiomyosarcoma, low-grade endometrial stromal sarcoma, undifferentiated endometrial sarcoma, adenosarcoma and carcinosarcoma. The distinctive biological behavior and poor overall survival of uterine sarcoma create challenges in the management of these tumors. We herein present a comprehensive review of taxonomy, epidemiology, pathology, imaging findings and natural history of a wide spectrum of uterine sarcomas.

Current concepts in the imaging of uterine sarcoma

OBJECTIVE. The purpose of our study was to evaluate the sonographic, contrast-enhanced CT, and gadolinium-enhanced MRI findings of primary malignant mixed mullerian tumors (MMMTs) of the uterus.CONCLUSION. Uterine MMMT most commonly presents as an intracavitary mass with coexistent dilatation of the endometrial canal. Tumors tend to appear hyperechoic on sonography, heterogeneously hypodense and ill defined on contrast-enhanced CT, and heterogeneously hyperintense on T2-weighted MR images with signal abnormalities indicating subacute hemorrhage on T1-weighted MR images. Myometrial invasion is common and has a predilection for the uterine fundus.

https://www.ajronline.org/doi/pdf/10.2214/AJR.07.3281

Primary Malignant Mixed Müllerian Tumor of the Uterus: Findings on Sonography, CT, and Gadolinium-Enhanced MRI

Adenosarcoma of the uterus: magnetic resonance imaging characteristics.

We report a case of uterine adenosarcoma demonstrated on magnetic resonance (MR) imaging. A 74-year-old woman with a large uterine mass underwent MR examination before total abdominal hysterectomy. Imaging revealed a markedly enlarged uterus with thin myometrium occupied by a large polypoid mass. The mass contained solid components with low intensity on T1-weighted images and high intensity on T2-weighted images compared to the myometrium and areas of small cysts.

https://www.jstage.jst.go.jp/article/mrms/10/4/10_4_251/_pdf

MR imaging of uterine adenosarcoma: case report and literature review.

https://www.ajronline.org/doi/pdf/10.2214/ajr.181.6.1811673

Sonography and MRI of Tamoxifen-Associated Müllerian Adenosarcoma of the Uterus

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Sonography and MRI of Tamoxifen-Associated Müllerian Adenosarcoma of the Uterus