MR findings of uterine PEComa in patients with tuberous sclerosis: report of two cases

Journal Article · Mon Apr 01 00:00:00 EDT 2019 · Abdominal Radiology (Online)

DOI:https://doi.org/10.1007/S00261-019-01918-3· OSTI ID:22923048

Nishio, Naoko; Kido, Aki ^[1]; Minamiguchi, Sachiko ^[2]; Kiguchi, Kayo; Kurata, Yasuhisa; Nakao, Kyoko Kameyama; Kuwahara, Ryo; Yajima, Ryo; Otani, Satoshi ^[1]; Mandai, Masaki ^[3]; Togashi, Kaori ^[1]; Minami, Manabu ^[4]

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1. Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine (Japan)
2. Kyoto University Graduate School of Medicine, Department of Diagnostic Pathology (Japan)
3. Kyoto University Graduate School of Medicine, Department of Gynecology and Obstetrics (Japan)
4. University of Tsukuba Hospital, Department of Radiology (Japan)

Tuberous sclerosis complex (TSC), a rare autosomal dominant neurocutaneous disorder, is characterized by the presence of benign congenital tumors in multiple organs. Neoplasms with perivascular epithelioid cell differentiation (PEComas), including angiomyolipoma (AML) and lymphangioleiomyomatosis (LAM), can occur in association with TSC. This report describes two cases of uterine PEComas presenting characteristic MR imaging features reflecting pathological findings. From MR images, both cases showed single or multiple large, irregularly shaped or lobulated hemorrhagic lesions within the myometrium. They differed from typical adenomyotic cysts in their large size and irregular margins. Histopathologic analysis revealed that the hemorrhage was caused by adenomyosis and tumor cells that proliferated in surrounding stroma of the hemorrhagic lesions, compatible with PEComas. Microscopic observation revealed an infiltrative growth pattern of PEComas, with small nodules formed. The tumor lesions, however, were difficult to detect on MR images. The myometrium showed normal appearance on both T1-weighted and T2-weighted images in both cases. We speculate that PEComas may infiltrate extensively into the myometrium even when the myometrium shows almost normal radiologic appearance.

• OSTI ID: 22923048
• Journal Information: Abdominal Radiology (Online), Vol. 44, Issue 4; Other Information: Copyright (c) 2019 Springer Science+Business Media, LLC, part of Springer Nature; Country of input: International Atomic Energy Agency (IAEA); ISSN 2366-0058
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CELL DIFFERENTIATION
CONGENITAL DISEASES
CYSTS
HEMORRHAGE
NEOPLASMS
NMR IMAGING
TUMOR CELLS
UTERUS