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Gastrointestinal Leiomyoma and Leiomyosarcoma: CT Differentiation

1998; Lippincott Williams & Wilkins; Volume: 22; Issue: 1 Linguagem: Inglês

10.1097/00004728-199801000-00012

1532-3145

Ho Jong Chun, Jae Young Byun, Kyung Ah Chun, Sung Eun Rha, Seung Eun Jung, Jae Mun Lee, Kyung Sub Shinn,

Soft tissue tumors and treatment

Purpose Our goal was to evaluate CT efficacy in differentiating gastrointestinal leiomyoma and leiomyosarcoma. Method We retrospectively reviewed CT scans of 45 patients (21 men, 24 women, mean age 55 years) with surgically proven gastrointestinal leiomyomas (n = 21) and leiomyosarcomas (n = 24) with respect to size, contour, enhancing pattern, mesenteric fat infiltration, calcification, ulceration, regional lymphadenopathy, direct invasion, distant metastasis, and growth pattern after visual inspection by two radiologists in agreement. On the basis of these CT features, subjective diagnosis was also categorized into three groups (Group I: probably benign, Group II: probably malignant, Group III: diagnostic malignant). The results were compared with the final histopathologic diagnosis. Results In addition to the features of direct invasion and distant metastasis suggesting diagnostic malignancy, the CT features favoring malignancy with statistical significance included larger size (>5 cm), lobulated contour, heterogeneous enhancement, mesenteric fat infiltration, ulceration, regional lymphadenopathy, and exophytic growth pattern (p < 0.005). However, calcification was not significant in differentiating the two entities (p = 0.25163). A subjective analysis revealed 89% sensitivity, 85% specificity, and 87% accuracy for diagnosis of leiomyosarcoma. Conclusion CT features are useful in differentiating leiomyoma and leiomyosarcoma in gastrointestinal tract.