Low-Grade Endometrial Stromal Sarcoma with a Nodule-in-Nodule Appearance in Preoperative Magnetic Resonance Images
Unenhanced pelvic MRI. (a) Sagittal T1-WI shows a tumor demonstrating isointensity with the normal myometrium. (b) Sagittal T2-WI showing a tumor with a nodule-in-nodule appearance within the myometrium. The small nodules show a low signal intensity at T1-WI and a high signal intensity at T2-WI. (c) Hypointense bands within the small nodules are signalized with an arrow on coronal T2-WI. (d) At diffusion-weighted imaging (), the small nodules show a higher signal intensity than the surrounding tumors, and the surrounding tumors show a relatively higher signal intensity than the normal myometrium. (e) Both small nodules and surrounding tumors show a low signal intensity in the apparent diffusion coefficient (ADC) map. The ADC values of the small nodule and main tumor are 0.73 and 0.82 (10-3 mm2/s), respectively.
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