Avoiding treatment of leiomyosarcomas: the role of magnetic resonance in focused ultrasound surgery

Amber Samuel, Fiona M. Fennessy, Clare M C Tempany, Elizabeth A Stewart

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: To report early diagnosis of a uterine leiomyosarcoma during screening for magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) for leiomyomas. Design: Case report. Setting: University hospital conducting an institutional review board-approved clinical trial. Patient(s): A 47-year-old premenopausal woman with presumed symptomatic leiomyomas for 5 years and minimal interval growth. Intervention(s): Magnetic resonance imaging screening protocol used as a routine part of MRgFUS treatment protocol. Main Outcome Measure(s): Surgical pathology report. Result(s): The diagnosis of leiomyosarcoma was suspected at the time of screening, and inadvertent treatment of a leiomyosarcoma was avoided. The patient underwent hysterectomy performed by her referring physician and confirmed the diagnosis of leiomyosarcoma. Conclusion(s): The possibility of inadvertent treatment of malignant disease and thus delayed diagnosis exists with all non-excisional therapies for uterine leiomyomas. The pretreatment imaging before MRgFUS in this case led to an expedited diagnosis of malignancy. Although this did not lead to a change in prognosis for this patient, careful review of magnetic resonance imaging before MRgFUS may allow early diagnosis for uterine malignancies.

Original languageEnglish (US)
JournalFertility and Sterility
Volume90
Issue number3
DOIs
StatePublished - Sep 2008
Externally publishedYes

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Keywords

  • diagnosis
  • focused ultrasound
  • image-guided surgery
  • Leiomyoma
  • leiomyosarcoma
  • magnetic resonance imaging

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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