Introduction/Background The aim of this study was to investigate a magnetic resonance imaging (MRI)-based definition of lower uterine segment (LUS) carcinoma.
Methodology We retrospectively reviewed 587 consecutive patients with endometrial cancer who underwent hysterectomy. LUS carcinoma was determined through pathological examination and MRI assessment. For imaging assessment, the location of the inner lining of the uterus was classified into four equal parts on a sagittal section image. A tumor was defined as LUS carcinoma when its thickest part was located in the second or the third part of the uterine fundus. LUS carcinoma was further divided into LUS in a narrow sense, upon which diagnosis was exclusively based on pathological findings, and LUS in a broad sense. The relationship between LUS carcinoma and probable Lynch Syndrome (LS) was investigated. Patients with loss of MSH2, MSH6, and PMS2 expression or those with tumors with loss of MLH1 and absence of MLH1 promoter methylation were diagnosed as probable LS.
Results LUS carcinoma was identified in 59 (10.2%) patients. Twenty-eight (47.5%) patients were categorized as LUS in a narrow sense and 31 (52.5%) as LUS in a broad sense. Among them, probable LS was identified in 12 (20.3%) cases. There was no difference in clinical profiles, including the prevalence of probable LS between the two categories.
Conclusion An expanded definition of LUS carcinoma might improve the detection of LS-related endometrial cancer.
Disclosure Nothing to disclose.
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