Abstract: Uterine sarcoma (US) is a rare malignant tumor with the characteristics of difficulty in diagnosis, high malignant degree, early metastasis, early recurrence and poor prognosis. Early diagnosis and surgical treatment are two key factors in improving prognosis, the preoperative diagnosis of uterine sarcoma, and staging, is of great clinical significance. There is no specific clinical manifestation of uterine sarcoma. Preoperative examinations such as the elevated levels of serum CA125 and lactate dehydrogenase (LDH) are suggestive, however they cannot be used as diagnostic indicators. When uterine sarcoma protruded into the uterine cavity, the cytological examination of endometrium could make a positive diagnosis. Imaging studies such as the magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) can be helpful to distinguish uterine sarcoma and benign uterine tumors. However, the clinical value of this combined imaging should be furtherly validated. Ultrasound-guided biopsy can obtain reliable pathological results, which cannot be used as a routine preoperative examination due to the related risks and complications. The comprehensive preoperative predictive systems of uterine sarcoma is constructed by the clinical signs, biomarkers and imaging.

Key words: Uterine sarcoma, Uterine Neoplasms, Sarcoma, Diagnosis, Magnetic Resonance Imaging