(a) MRI (T1 weighted, after Gadolinium injection): Enlarged uterus with central hypodense area. (b) ThinPrep Pap smear showing numerous spindle cells with marked anysocytosis, anisonucleosis and chromatin condensation. The background shows granular tumor diathesis and blood (Pap, 400x). (c) ThinPrep Pap smear: Multinucleated giant cells in association with single spindle and more epithelioid appearing malignant cells (PAP, 400x). (d) Hysterectomy gross specimen showing anterior and posterior endometrial cavities occupied with tumor with central hemorrhagic area. (e) Histologic sections showing high-grade sarcoma with osteoclast-like giant cells, numerous mitotic figures and individual cell apoptosis (H&E, 200x). (f) High power view of histological sections showing undifferentiated endometrial sarcoma with marked cellular pleomorphism and atypical mitoses (H&E, 400x).