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Open Access
CC BY 4.0 · Journal of Gastrointestinal and Abdominal Radiology
DOI: 10.1055/s-0045-1812100
Review Article

Imaging in Uncommon Uterine Malignancies

Authors

  • Divij Agarwal

    1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, National Capital Territory of Delhi, India

  • Smita Manchanda

    1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, National Capital Territory of Delhi, India

  • Ankita Aggarwal

    1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, National Capital Territory of Delhi, India

  • Ekta Dhamija

    2   Department of Diagnostic and Interventional Onco-Radiology, DR. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, National Capital Territory of Delhi, India

  • Seema Singhal

    3   Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, National Capital Territory of Delhi, New Delhi, India

  • Jyoti Meena

    3   Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, National Capital Territory of Delhi, New Delhi, India
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Abstract

This review provides a comprehensive overview of the classification and imaging characteristics of uncommon uterine malignancies, guided by the latest World Health Organization classification of female genital tumors (fifth edition, 2020). We discuss the imaging features of rare entities, including leiomyosarcoma, endometrial stromal sarcoma, stromal tumor of uncertain malignant potential, carcinosarcoma, adenosarcoma, perivascular epithelioid cell tumor, and uterine tumors resembling ovarian sex-cord tumors. Although these malignancies often present with nonspecific and overlapping imaging appearances, advances in cross-sectional imaging (particularly magnetic resonance imaging [MRI]) play a critical role in tumor detection, characterization, staging, and treatment planning. Key MRI findings, such as signal intensity patterns, enhancement characteristics, and diffusion-weighted imaging, can help to narrow differential diagnoses and inform management strategies. By emphasizing distinctive imaging features and their clinical relevance, this review aims to enhance diagnostic confidence and multidisciplinary care for patients with these challenging uterine malignancies.

Keywords

uterus - MRI - sarcoma - mesenchymal - malignancy - leiomyosarcoma - leiomyomas - endometrial stromal sarcoma - carcinosarcoma - STUMP


Publication History

Article published online:
14 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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