There is a spectrum of endometrial stromal neoplasms which extends from borderline benign to low-grade malignant. These have a definite tendency to metastasize. Proper diagnosis is important because they have an excellent prognosis with long-term survival even with evidence of recurrence or metastases. Aggressive treatment is mandatory. This represents the first report of the radiographic spectrum of the entity as seen in 7 cases. The patients are usually in middle age and present with vaginal bleeding. Not previously stressed is the presence of diarrhea in many of them. Prior uterine surgery even for "fibroids" should be viewed with suspicion. A pelvic mass was usually seen on plain films, intervenous pyelogram (IVP), or barium enema (BE). Ultrasound showed a mixed cystic configuration of the tumors, whereas computed tomography (CT) demonstrated a definitely solid mass. The lesions simulated primary carcinoma of the colon, retroperitoneal tumor, and pelvic inflammatory disease. Metastases to the lung and the bone were also identified.