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Congress: ECR26
Poster Number: C-10945
Type: Poster: EPOS Radiologist (educational)
Authorblock: M. Takeuchi, K. Matsuzaki, M. Harada; Tokushima/JP
Disclosures:
Mayumi Takeuchi: Nothing to disclose
Kenji Matsuzaki: Nothing to disclose
Masafumi Harada: Nothing to disclose
Keywords: Genital / Reproductive system female, MR, MR-Diffusion/Perfusion, MR-Functional imaging, Diagnostic procedure, Cancer, Cysts, Tissue characterisation
Learning objectives To review a spectrum of non-neoplastic diseases that can mimic neoplasms in the female pelvis.To demonstrate look-alike tumors and tumor-like lesions on imaging, and to highlight imaging clues for differentiating tumor-like lesions from true neoplasms using problem-solving MRI techniques.
Read more Background Non-neoplastic conditions of the uterus and adnexa often present with tumor-like appearances. In addition, normal pelvic organs may undergo physiological or hormonally induced changes, mimicking neoplasms as pseudotumoral “Don’t Touch” lesions. These conditions are common in young women, sometimes associated with hormonal activity, and frequently encountered during pregnancy. A wide spectrum of clinical and imaging features of such lesions is compared to look-alike benign and malignant tumors with therapeutic strategies.
Read more Findings and procedure details [Look-alike ill-demarcated T2-low enlarged uterus] [fig 1]  Tumor-like lesion: AdenomyosisTumor: Low-grade endometrial stromal sarcoma [Adenomyosis] Common non-neoplastic disease characterized by the presence of ectopic endometrium within the myometrium Affects multiparous, premenopausal women with dysmenorrhea, menorrhagia, and abnormal genital bleeding  [Mimicker: Low-grade Endometrial Stromal Sarcoma: LG-ESS] Rare malignant mesenchymal tumor affecting young women May mimic adenomyosis, and characteristic myometrial invasion as “Bag of worms” (preserved T2-low smooth muscle bundles within T2-high tumor) Diffusion restriction (+)  [Decidualized Adenomyosis] Decidualization during pregnancy may also occur in ectopic endometrial tissue in adenomyosis Multiple T2-high dilated, decidualized endometrial...
Read more Conclusion Accurate diagnosis of tumor-like and pseudotumoral lesions using problem-solving MR techniques is essential for the appropriate management of patients to avoid excess surgical procedures and to preserve fertility and function.
Read more Personal information Mayumi Takeuchi, MD, PhDDepartment of Radiology, Tokushima University3-18-15, Kuramoto-cho, Tokushima, zip: 7708503, JapanTEL: 81-88-633-9283, FAX: 81-88-633-7468E-mail address: [email protected]
Read more References MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics 25, 2005 Adenomyosis: usual and unusual imaging manifestations, pitfalls, and problem-solving MR imaging techniques. Radiographics 31, 2011 MR imaging of endometrial stromal sarcoma: correlation with pathologic findings. AJR 173, 1999 MR Imaging of uterine sarcomas: a comprehensive review with radiologic-pathologic correlation. Abdom Radiol 46, 2021 Decidualized adenomyosis during pregnancy and post delivery: three cases of magnetic resonance imaging findings. Abdom Imaging 38, 2013 Sustained uterine contractions: a cause of hypointense myometrial bulging....
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