{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:52Z","timestamp":1787027932567,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Low-grade endometrial stromal sarcoma (LGESS) is a rare uterine malignancy that causes non-specific symptoms which presents more typically in younger women compared to other uterine sarcomas. Preoperative diagnosis of myometrial LGESS is challenging, as it is frequently mistaken for a benign uterine mass, such as a degenerating leiomyoma. Despite its rarity, the imaging findings of LGESS are highly variable, complicating the diagnostic process. Characteristic findings on magnetic resonance imaging T2-weighted imaging (T2WI)\u2014including intra-tumoral low signal intensity (SI) bands (correlating with preserved myometrial bundles separated by tumor cells on histopathology), cystic\/necrotic changes, and absence of a speckled appearance\u2014have been significantly associated with LGESS. Additionally, apparent diffusion coefficient mapping can aid in the characterization of uterine masses. Case Presentation: We present a case of LGESS initially misdiagnosed as red degeneration of a uterine leiomyoma (RDL) due to a peripheral rim showing high SI on T1-weighted imaging and low SI on T2WI, which was interpreted as a thrombosed vessel. Histopathology demonstrated necrotic tissue outlined by normal uterine tissue, corresponding to the peripheral rim. We suggest that susceptibility-weighted imaging could have aided in distinguishing between the two conditions due to its high sensitivity to blood products. Moreover, diffusion-weighted imaging revealed restriction along T2 low SI bands, with no restrictions within the bands themselves, potentially indicating a viable tumor along preserved myometrium. Conclusions: These imaging features may provide valuable insights for diagnosing LGESS and differentiating it from RDL, supporting further research on LGESS imaging characteristics.<\/jats:p>","DOI":"10.3390\/diagnostics15010018","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T19:19:32Z","timestamp":1735154372000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Low-Grade Endometrial Stromal Sarcoma: A Case Report of a Rare Uterine Malignancy Mimicking Degenerative Uterine Leiomyoma in a Nulliparous Woman"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8395-8696","authenticated-orcid":false,"given":"Hyun Kyung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Radiology, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Jeonbuk, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3125-2991","authenticated-orcid":false,"given":"Weon","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Jeonbuk, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Department of Pathology, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Jeonbuk, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Soo","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jeonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Jeonbuk, Republic of Korea"},{"name":"Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Jeonbuk, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.pathol.2017.11.086","article-title":"Endometrial stromal sarcomas and related neoplasms: New developments and diagnostic considerations","volume":"50","author":"Hoang","year":"2018","journal-title":"Pathology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1159\/000494225","article-title":"Low-Grade Endometrial Stromal Sarcoma\u2014A Review","volume":"41","author":"Thiel","year":"2018","journal-title":"Oncol. 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