title: Avoiding treatment of leiomyosarcomas: the role of magnetic resonance in focused ultrasound surgery.
abstract: OBJECTIVE
  To report early diagnosis of a uterine leiomyosarcoma during screening for magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) for leiomyomas.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital conducting an institutional review board-approved clinical trial.
  
  
  METHODS
  A 47-year-old premenopausal woman with presumed symptomatic leiomyomas for 5 years and minimal interval growth.
  
  
  METHODS
  Magnetic resonance imaging screening protocol used as a routine part of MRgFUS treatment protocol.
  
  
  METHODS
  Surgical pathology report.
  
  
  RESULTS
  The diagnosis of leiomyosarcoma was suspected at the time of screening, and inadvertent treatment of a leiomyosarcoma was avoided. The patient underwent hysterectomy performed by her referring physician and confirmed the diagnosis of leiomyosarcoma.
  
  
  CONCLUSIONS
  The possibility of inadvertent treatment of malignant disease and thus delayed diagnosis exists with all non-excisional therapies for uterine leiomyomas. The pretreatment imaging before MRgFUS in this case led to an expedited diagnosis of malignancy. Although this did not lead to a change in prognosis for this patient, careful review of magnetic resonance imaging before MRgFUS may allow early diagnosis for uterine malignancies.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Samuel
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Fennessy
authors.forename: Clare M C
authors.initials: CM
authors.lastname: Tempany
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stewart
mesh_terms: D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000628:therapy*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008875:Middle Aged; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000628:therapy*