EP26.08: Imaging in gynecological disease: clinical and ultrasound characteristics of uterine malignant mixed Müllerian tumours

To describe the clinical and ultrasound features of uterine malignant mixed Müllerian tumours (uMMMTs). From the databases of 9 specialised ultrasound (US) centres we identified patients with uMMMT who underwent surgery between 2001-2022. Clinical, histopathological and US information was collected. Available US images and videoclips were reviewed by two experienced ultrasound examiners (V.C; D.F) to search for specific US features. We identified 189 cases of uMMMTs with available US images (128) or with detailed US report. Median age was 69 years (43-89). Most patients (84%) presented with uterine bleeding. At US the median tumour AP diameter was 48 mm (8-188mm), median tumour maximum diameter 60 mm (15-320mm). In most cases tumour echogenicity was non-uniform (57%) or uniform-hyperechoic (17%), endometrial-myometrial junction interrupted (56%), tumour vascularisation moderate (47%) or abundant (30%). The most common vascular pattern was multiple vessels with multifocal origin (31%) or scattered vessels (20%). Cervical invasion was seen in 39% cases. In 80% of tumours with available US images (103/128) the uterus had the appearance of a cut papaya (figure 1): globular shape, inhomogeneous tissue in a large uterine cavity, frequent cervical involvement. On ultrasound, most uMMMTs appear as large tumours with non-uniform gray-scale ultrasound morphology, non-defined endometrial midline, and moderate or abundant vascularisation. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.