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Magnetic resonance imaging findings in atypical polypoid adenomyoma.

Abstract：

OBJECTIVES:This article describes magnetic resonance imaging (MRI) findings in 3 cases of atypical polypoid adenomyoma (APAM). METHODS:Clinical and MRI manifestations of 3 patients with APAM were evaluated. High b value diffusion-weighted and dynamic contrast-enhanced images were performed. The size, shape, site of origin, and signal intensity (SI) of MRI findings were evaluated. RESULTS:All patients (age range, 37-47 years; mean age, 40 years) had a chief complaint of atypical genital bleeding with no history of pregnancy. In 2 cases, cytology of the endometrium was positive, and pathological analysis of curettage specimens indicated endometrioid adenocarcinoma. The MRI revealed an endometrial polypoid mass arising from the upper corpus (50%) or lower uterine segment (50%). Except for 1 tumor that seemed to invade the myometrium of the uterine wall due to its irregular margin, all tumors were well circumscribed. On T2-weighted MRI scans, the SI of the tumor was homogenous and marginally hyperintense, and contained markedly hyperintense cystic foci. On T1-weighted images, all the tumors were isointense relative to the myometrium, and in 1 case, a number of cystic foci showed high SIs. In a dynamic contrast-enhanced study, solid portions other than the cystic foci showed contrast enhancement in the arterial phase and demonstrated a washout pattern or plateau pattern in the late phase. All tumors demonstrated high SIs on diffusion-weighted images. CONCLUSIONS:Differentiating APAM from other malignant polypoid uterine endometrial tumors may still pose difficulties, especially when the tumor seems to invade the myometrium on MRI. Comprehensive clinical information about the patient including age, pathological assessment of the endometrium, and MRI findings should be essential to provide indication for a diagnosis of APAM.

journal_name

J Comput Assist Tomogr

journal_title

Journal of computer assisted tomography

authors

Nakai G,Kitano R,Yamamoto K,Higashiyama A,Juri H,Tsuboyama T,Yamamoto K,Yamada T,Hirose Y,Ohmichi M,Narumi Y

doi

10.1097/RCT.0000000000000169

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

32-6

issue

eissn

0363-8715

issn

1532-3145

journal_volume

pub_type

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Magnetic resonance imaging findings in atypical polypoid adenomyoma.