Introduction

Abstract

Uterine sarcomas are rare tumors of mesodermal origin and are highly malignant. The radiological features are nonspecific and may be indistinguishable from those of endometrial carcinoma. However, uterine sarcomas tend to be large and heterogeneous with areas of hemorrhage and cystic necrosis. The malignant mixed Müllerian tumor (MMMT) contains both epithelial and sarcomatous elements and is the most common of the uterine sarcomas. It is known that a portion of patients with MMMT have a history of pelvic radiation therapy. Leiomyosarcoma is the second most common uterine sarcoma and may arise either de novo from uterine musculature or connective tissue of uterine blood vessels, or in a pre-existing leiomyoma. Endometrial stromal sarcoma is the third most common uterine sarcoma and originates from the endometrium, but invariably invades the myometrium. Like other lymphomas, both primary and secondary lymphoma can involve the uterus. Imaging findings for lymphoma involving the uterus are nonspecific, but diffuse uterine enlargement with a somewhat lobular contour and relatively homogeneous attenuation with multiple lymphadenopathy can suggest lymphoma involvement of the uterus. Metastasis to the uterus from an extrapelvic neoplasm can occur. A lipomatous tumor originating in the uterus is rare, but the presence of fat within a uterine tumor is virtually diagnostic of a lipomatous uterine tumor.