婦人科―子宮肉腫

Uterine sarcoma

子宮肉腫の術前診断は時に困難であり，逆に良性の子宮筋腫が子宮肉腫と紛らわしい所見を呈することもまれではなく，治療方針の決定のうえでこれらの鑑別は重要である。本稿では子宮肉腫の診断の決め手となる画像所見や臨床所見について，症例の提示とともに解説する。

Preoperative diagnosis of uterine sarcoma is occasionally difficult, and conversely, it is not uncommon for benign leiomyomas to have imaging findings mimicking uterine sarcoma, making differential diagnosis based on MRI important in determining treatment strategy. The presence of massive coagulative necrosis with hemorrhage in leiomyosarcoma, characteristic myometrial invasion pattern in low-grade endometrial stromal sarcoma, unrestricted diffusion of low-grade sarcoma components with scattered small epithelial cysts in adenosarcoma, and heterogeneous signal pattern and strong contrast enhancement in carcinosarcoma compared to endometrial carcinoma may be useful diagnostic MRI findings.