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First published online August 6, 2007
British Journal of Radiology (2008) 81, 73-81
© 2008 British Institute of Radiology
doi: 10.1259/bjr/18595145
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Radiological imaging features of non-uterine leiomyosarcoma

P J O'Sullivan, MRCPI, FFR, RCSI, A C Harris, FRCR and P L Munk, MDCM, FRCPC

Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada V5Z 1M9


Figure 1
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  		Figure 1. A 75-year-old woman with large inoperable retroperitoneal leiomyosarcoma. (a) Axial post-contrast CT shows marked internal vascularity. (b) The tumour invades the left renal vein (arrow). (c) Tumour extension via the inferior vena cava to the right atrium (arrow).

 

Figure 2
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  		Figure 2. A 52-year-old man with leiomyosarcoma of the prostate: large heterogeneous mass with central necrosis invading the bladder and abutting the anterior wall of the rectum.

 

Figure 3
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  		Figure 3. An 80-year-old man with multiple, rounded, pulmonary metastatic nodules seen in leiomyosarcoma.

 

Figure 4
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  		Figure 4. A 61-year-old woman with large retroperitoneal leiomyosarcoma. (a) Axial post-contrast CT shows extensive tumour encasing the aorta and inferior vena cava. (b) Multiple liver metastases with peripheral rim enhancement and central necrosis. (c) A lytic metastasis to the left ilium is also seen.

 

Figure 5
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  		Figure 5. A 70-year-old woman with leiomyosarcoma of the right ureter. (a) Axial post-contrast CT shows a round heterogeneously enhancing mass in the position of the distal right ureter (arrow). (b) Large necrotic hepatic metastases are often seen in leiomyosarcoma.

 

Figure 6
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  		Figure 6. A 68-year-old woman with leiomyosarcoma of the mesentery. (a) Axial post-contrast CT shows a lobulated heterogeneous mass in the small bowel mesentery. (b) Enhancing metastases above iliac vessels (white arrow) and necrotic metastasis to the right iliacus (black arrow). (c) Serosal metastasis to the right round ligament (curved arrow).

 

Figure 7
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  		Figure 7. A 67-year-old man with leiomyosarcoma of the anterior compartment of the thigh. Sagittal T1 (a), sagittal T2 (b) and axial T2 (c) MR images with fat saturation demonstrate the large, multiloculated anterior compartment mass within the deep soft tissues. Images courtesy of Dr L M White, Mt Sinai Hospital, Toronto, ON.

 

Figure 8
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  		Figure 8. A 62-year-old woman with leiomyosarcoma of the medial distal thigh. (a) Coronal T1 image shows a uniform, low-signal, soft tissue tumour (arrow). (b) Coronal T2 image demonstrates a heterogeneous signal. (c) Axial T1 fat-saturation image shows heterogeneous enhancement following gadolinium.

 

Figure 9
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  		Figure 9. A 55-year-old woman with leiomyosarcoma of the medial right upper thigh. (a) T1 axial image demonstrates a homogeneous lesion isointense to muscle. (b) Axial T2 image shows areas of intermediate signal relative to fat. (c) Coronal short tau inversion recovery (STIR) image shows uniform high-signal intensity with thin internal septations.

 

Figure 10
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  		Figure 10. A 23-year-old man with leiomyosarcoma of the distal femur. (a) Anteroposterior radiograph shows a permeative lytic lesion of the distal femoral metaphysis extending to the epiphysis. (b) Axial T1 weighted image shows replacement of the marrow cavity with homogeneous hypointense tumour and a small area of cortical breakthrough laterally. (c) Axial T2 weighted image shows areas hypointense to fat. (d) Coronal short tau inversion recovery (STIR) image shows a diffuse high signal.

 

Figure 11
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  		Figure 11. A 56-year-old man with leiomyosarcoma of the tibia. (a) Sagittal T1 weighted MR image shows linearly orientated tumour occupying the proximal diaphysis of the tibia. (b) The tumour is hyperintense on this sagittal T2 weighted image with fat saturation demonstrating extension into the soft tissues. (c) Axial T1 fat-saturation image post-gadolinium shows tumour enhancement with cortical permeation and an adjacent soft tissue component. Images courtesy of Dr L M White, Mt Sinai Hospital, Toronto, ON.

 




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