ABSTRACT
Uterine sarcomas constitute only 3% of all uterine malignancies. The World Health Organization classifies uterine sarcomas into two main groups: mesenchymal tumors and mixed epithelial and mesenchymal tumors. Most reports analyzing ultrasound features of uterine sarcomas did not distinguish between leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS). LMS is the most frequent uterine sarcoma, followed by ESS. On ultrasound, uterine leiomyosarcomas are reportedly large, oval-shaped tumors, with an inhomogeneous content owing to tumor tissue and central necrosis and hemorrhage, leading to a "bizarre" internal echo pattern. LMS presents with symptoms similar to those of benign uterine leiomyoma, such as bleeding, pelvic pain, increase of abdominal girth, uterine palpable mass, or pelvic pressure. Most cases of LMS appear in postmenopausal women. Like LMS, the main symptom associated with EES is abnormal uterine bleeding. Most reports analyzing ultrasound features of uterine sarcomas did not distinguish between LMS and EES.
