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Primary Malignant Mixed Müllerian Tumor of the Uterus: Findings on Sonography, CT, and Gadolinium-Enhanced MRI

Sze Yiun Teo1, Kemi T. Babagbemi2, Hope E. Peters2 and Koenraad J. Mortele1

1 Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St., Boston, MA 02115.
2 Division of Ultrasound, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.


Figure 1
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  		Fig. 1 —74-year-old woman with 1 week of postmenopausal bleeding. Sagittal transvaginal sonography image shows ill-defined hyperechoic uterine mass (arrows) with coexistent dilatation of endometrial canal and deep invasion of fundal myometrium.

 

Figure 2
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  		Fig. 2A —75-year-old woman with postmenopausal bleeding. Patient was diagnosed with breast cancer 24 years earlier and treated with tamoxifen. Axial contrast-enhanced CT image shows ill-defined hypodense mass (arrow) in endometrial canal.

 

Figure 3
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  		Fig. 2B —75-year-old woman with postmenopausal bleeding. Patient was diagnosed with breast cancer 24 years earlier and treated with tamoxifen. Axial contrast-enhanced CT image shows transgression of fundal myometrium by uterine mass (arrows).

 

Figure 4
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  		Fig. 3A — 19-year-old woman with severe vaginal bleeding. Sagittal transvaginal sonography image shows large hyperechoic uterine mass with dilatation of endometrial canal (arrowheads) and large extrauterine component (arrows).

 

Figure 5
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  		Fig. 3B — 19-year-old woman with severe vaginal bleeding. Axial contrast-enhanced CT image confirms presence of large hypodense extrauterine mass (arrows).

 

Figure 6
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  		Fig. 3C — 19-year-old woman with severe vaginal bleeding. Axial contrast-enhanced CT image at lower level shows that mass (arrows) arises in endometrial canal that is dilated.

 

Figure 7
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  		Fig. 3D — 19-year-old woman with severe vaginal bleeding. Coronal T2-weighted MR image shows heterogeneous hyperintense appearance of mass (arrows) and fundal myometrial invasion (arrowheads) with extrauterine extension.

 

Figure 8
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  		Fig. 3E — 19-year-old woman with severe vaginal bleeding. Coronal T1-weighted MR image shows presence of high-signal-intensity areas (arrows) within hypointense mass.

 

Figure 9
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  		Fig. 3F — 19-year-old woman with severe vaginal bleeding. Coronal gadolinium-enhanced T1-weighted MR image shows heterogeneous enhancement of tumor.

 

Figure 10
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  		Fig. 3G — 19-year-old woman with severe vaginal bleeding. Sagittal gadolinium-enhanced T1-weighted MR image shows heterogeneous but avid enhancement of intra- and extrauterine components.

 

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