Alia Yassine Kassab, Mehdi Salmane, Lina Lasri, Hounayda Jerguigue, Youssef Omor, Rachida Latib
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 1
Date of Publication: 2026/01/23
Uterine fibroids are common benign smooth muscle tumors, whereas uterine sarcomas are rare but aggressive malignant mesenchymal neoplasms, and distinguishing between them remains a diagnostic challenge because of overlapping clinical presentations and imaging characteristics. We describe two cases illustrating this difficulty. The first case involved a seventy-five-year-old postmenopausal woman presenting with chronic pelvic pain; magnetic resonance imaging showed features concerning for a malignant uterine mass, yet histopathological examination confirmed benign fibroids. The second case involved a sixty-eight-year-old woman with mild metrorrhagia and a cervical mass; imaging findings were suspicious for malignancy, and biopsy revealed granulocytic sarcoma. These cases demonstrate that symptoms such as pelvic pain, abnormal uterine bleeding, and mass effect may be encountered in both benign and malignant uterine tumors, complicating the initial diagnostic approach. Magnetic resonance imaging, particularly when including diffusion-weighted sequences, can improve the assessment of tumor characteristics, but radiologic evaluation alone remains insufficient for confident discrimination between fibroids and uterine sarcomas. Definitive diagnosis continues to rely on histopathological analysis, which guides appropriate therapeutic decisions. While fibroids may be managed conservatively or surgically depending on symptoms, uterine sarcomas require prompt radical management, often including total hysterectomy with consideration of adjuvant therapy. These cases highlight the importance of clinical vigilance and the need for careful interpretation of imaging findings when evaluating uterine masses, particularly in postmenopausal women, in whom the risk of malignancy is higher. Early and accurate diagnosis is essential to ensure optimal patient outcomes.
uterine sarcoma, granulocytic sarcoma, uterine fibroid, leiomyoma, pelvic pain, magnetic resonance imaging, case report
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