Magnetic resonance imaging features of endometrial stromal sarcoma: a case description

Chen Chen, You Qiang Hu, Xiao Ming Zhang


Endometrial stromal sarcoma (ESS) originates from mesenchyma or naive mesenchyma, accounting for only 0.2% of all uterine malignancies and 10–15% of uterus sarcoma. The annual incidence rate is 1–2 per million and the average age is 40–45 years old (1,2). ESS has a more preferable prognosis when compared with the more common endometrial carcinomas of epithelial origin. In 2003, ESS was classified into endometrial stromal nodule, low-grade endometrial stromal sarcoma (LGESS), high-grade ESS, undifferentiation endometrial stromal sarcoma (UES) by WHO. Early detection is necessary so to increase survive rate. Generally on magnetic resonance imaging (MRI) ESS shows the uterine body is enlarged with a well-circumscribed mass of inhomogeneous signals. In some circumstance, ESS presents hyperintensity on T2-weighted images, and isointensity relative to the myometrium on T1-weighted images. Moreover, obvious hyperintensity was observed on diffusion weighted imaging (3-5). Interestingly, in some cases, ESS may have a characteristic low-intensity rim on T2-weighted images (6). We herein present a case of a LGESS.