gynecology and obstetrics
Uterine Sarcomas
Diagnosis of Uterine Sarcomas
Histology, most often after surgical removal Symptoms suggesting uterine sarcoma usually prompt transvaginal ultrasonography and endometrial biopsy or dilation and curettage (D & C). However, these tests have limited sensitivity for sarcoma. Endometrial stromal sarcoma and uterine leiomyosarcoma are often incidentally diagnosed histologically after hysterectomy or myomectomy. If cancer is identified preoperatively, CT or MRI is typically done. If uterine sarcoma is diagnosed after surgical removal, imaging is recommended, and surgical re-exploration can be considered to complete staging. Screening for Lynch syndrome (hereditary nonpolyposis colorectal cancer) is not usually done when patients have uterine sarcoma because this genetic syndrome increases risk of endometrial carcinoma, not sarcoma. Staging is done surgically (see tablesand). 