Analysis of the causes of misdiagnosis of uterine fibroids as endometrial cancer by ultrasound and ultrasonographic features
NIAN Mengyu
ZHOU Jing
LI Zhentao
XU Mingjing
DIAO Xiaomei
Abstract：Objective To analyze the causes of misdiagnosis of uterine fibroids as endometrial cancer and the ultrasonographic features.Methods A patient who was initially misdiagnosed as having endometrial cancer in April 2023 but was eventually confirmed to have uterine fibroids was selected.By reviewing and analyzing the ultrasound and clinical data of the patient,the common ultrasonographic features of uterine fibroids and the key points for differentiating them from endometrial cancer were summarized.In the meantime,the causes of misdiagnosis were analyzed,and suggestions for improving the diagnostic accuracy were proposed.Results The patient presented with irregular vaginal bleeding for 1 year.Physical examination showed a uterus enlarged to the size of a 70+d gestation with an irregular surface.Ultrasound examination showed the possibility of endometrial cancer,but pathological examination of a diagnostic curettage sample only showed smooth muscle tissue.Contrast-enhanced magnetic resonance imaging revealed a submucosal uterine fibroid(low signal intensity on T2-weighted imaging with clear borders).After conservative treatment failed,hysterectomy was performed.The pathological diagnosis was uterine leiomyoma(4.0 cm×2.6 cm in size,with a gray-white,whorled cut surface and microscopically observed palisading arrangement of smooth muscle cells).The misdiagnosis lasted 33 d.The patients were followed up for 6 months with good prognosis.Conclusion Generally,ultrasound examination can quickly and accurately obtain the sonographic features of uterine fibroids.However,when the fibroids are large in size or have special pathological types and locations,they may be misdiagnosed as other uterine diseases.During the ultrasound examination,paying attention to observing the details of the images and combining the relevant medical history are conductive to avoiding missed diagnosis and misdiagnosis.
Keywords：uterine fibroidmisdiagnosisendometrial carcinomaultrasonographyultrasonographic featuresmagnetic resonance imagingdifferential diagnosis
Publication Date：2026-03-13
Online Publishing Date：2026-03-20(First online date of this platform, not the publication date of the document)
Pages：6( 12-17 )