Endometrial stromal sarcoma: An aggressive uterine malignancy (original) (raw)

High-Grade Endometrial Stromal Sarcoma :A Case Report

GLOBAL JOURNAL FOR RESEARCH ANALYSIS

Uterine sarcomas are tumors of poor prognosis characterized by a great histopathological heterogeneity. High endometrial stromal sarcomas (ESS) occurring at a late age, with high mitotic activity and / or tumor necrosis, are very poorly prognostic tumors. If it is accepted that the standard treatment of uterine sarcomas is surgical, the place of adjuvant treatment remains controversial. We report a case of a high-grade ESS referred to initially on MRI and diagnosed on pathological examination of a hysterectomy performed in a 64-year-old postmenopausal woman with postmenopausal bleeding.

Endometrial stromal sarcome – rare uterine tumor. A case report and literature review

2018

Endometrial stromal sarcoma (ESS) is uncommon uterine malignant tumor and makes approximately 0.2 % of all gynecological malignancies. It is the rarest tumor in the group of mesenchymal uterine tumors. Diagnosis may be difficult, since differentiation between several soft-tissue uterine neoplasms such as highly cellular leiomyoma, cellular endometrial polyp, low-grade Mullerian carcinosarcoma and adenomyosis is tricky. Treatment is surgical, hysterectomy and bilateral adnexectomy is obligatory, the role of lymphadenectomy is still controversial. Since ESS is hormone dependent tumor, hormone therapy as adjuvant therapy can be taken into consideration. In this article we present a 57-yearold patient, clinically asymptomatic, with peculiar TV ultrasound feature, and ESS diagnosed on patho-histologically after operation due to presumed benign diagnosis

Endometrial stromal sarcoma of the uterus: analysis of 25 patients

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2003

Objective: To analyze the prognostic factors in endometrial stromal sarcoma (ESS). Methods: Prognostic factors and adjuvant treatment of endometrial stromal sarcoma in 25 patients were evaluated retrospectively. Results: The mean age of the group was 43. In 58% of the patients, the presenting sign was vaginal bleeding. The median total survival was 55 months while the disease free survival (DFS) was 49 months. Disease recurred in eight patients, in three of whom tumors were confined to the pelvis. Seventeen patients were alive without disease. Four patients died because of the disease. The 5-year survival rate for patients with low-grade (LGESS) disease was 92%, and 85% in high-grade (HGESS) disease. Conclusion: In multivariate analyzes, tumor grading was the only prognostic factor in endometrial stromal sarcoma (P ¼ 0:0026).

Endometrial stromal sarcoma: clinico-pathological report of four cases and review of the literature

Rom J Morphol …, 2008

Endometrial stromal sarcoma (ESS) represents a very rare pathological entity occurring as a malignant disease in women genital sphere. Our clinical report is based on a group of four women aged 37, 48, 50 and 70-year-old, that have been histologically diagnosed with endometrial stromal sarcoma. The most common symptom sending the patient to the physician has been the vaginal bleeding, occurring in all patients. Other associated symptoms were the abdominal enlargement and the presence of the pelviabdominal mass generated by the tumor, low to medium abdominal pain or polakiuria. Two patients were diagnosed with ESS after accomplishing a biopsic curettage of the uterus. Total abdominal hysterectomy and salpingo-oophorectomy have been successfully performed for all of the patients. Adjuvant therapy-radiotherapy has been administered to three patients. At this time, none of the patients died of the disease. Our paper also includes a concise review of the literature in order to have an up-to-date conception regarding diagnosis, therapy and outcome for ESS.

Endometrial stromal sarcoma in a 27-year-old woman. Case report and literature review

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2018

Endometrial stromal tumors are very rare, representing approximately 0.2% of uterine malignancies, having an incidence of one to two from a million of women. The diagnosis cannot be established by imaging, it is histopathological only, often necessitate supplementary immunohistochemistry tests. We report the case of a 27-year-old woman who had an initial diagnosis, in another hospital, of uterine adenomyoma, established by dilatation and uterine curettage and then by subsequently histopathological exam. This diagnosis led to an initial non-oncological surgery, with interannexial total hysterectomy. The establishment of the final histopathological diagnosis of stromal endometrial sarcoma has led to a serious reassessment of the case. Making a review of the literature, we found very few cases of endometrial stromal sarcoma in young women less than 30 years old and we have not identified any clear strategy of treatment. However, from precautionary and considering that may be at risk, e...

Endometrial stromal sarcoma- A case report

IP innovative publication pvt. ltd, 2019

Endometrial stromal sarcomas are rare malignant tumours of the uterus. Most details about this tumour is obtained from previous case reports. In most of the cases, diagnosis is made only postoperatively. A 29 year old female, came with complaints of heavy menstrual bleeding, lower abdominal pain, mass in lower abdomen for 2 months. Clinical examination and investigations showed bulky irregularly enlarged uterus probably Fibroid Uterus. Patient was planned for Myomectomy. Intraoperatively, uterus was irregularly enlarged with cauliflower like growth of size 7 x 5 cm over fundus suggestive of Carcinoma. Total abdominal hysterectomy with bilateral salphingo oophorectomy with bilateral pelvic lymphnode dissection with infracolic omentectomy was done. Histopatholgy examination revealed as Low Grade Endometrial Stromal Sarcoma with Negative Lymph Node Spread. Postoperatively, Patient was evaluated for ER sensitivity and started on Tab. Anastrazole.

Endometrial stromal sarcoma: A review of rare mesenchymal uterine neoplasm

Journal of Obstetrics and Gynaecology Research, 2020

Objective: This review aims to analyze the pathological aspects, diagnosis and treatment of rare mesenchymal uterine tumors. Methods: On August 2019, a systematic review of the literature was done on Pubmed, MEDLINE, Scopus, and Google Scholar search engines. The systematic review was carried out in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes statement (PRISMA). The following words and key phrases have been searched: "endometrial stromal sarcoma", "low-grade endometrial stromal sarcoma", "high-grade endometrial stromal sarcoma", "uterine sarcoma", "mesenchymal uterine tumors" and "uterine stromal sarcoma". Across these platforms and research studies, five main aspects were analyzed: the biological characteristics of the neoplasms, the number of cases, the different therapeutic approaches used, the follow-up and the oncological outcomes. Results: Of the 94 studies initially identified, 55 were chosen selecting articles focusing on endometrial stromal sarcoma. Of these fifty-five studies, 46 were retrospective in design, 7 were reviews and 2 randomized phases III trials. Conclusion: Endometrial stromal sarcomas are rare mesenchymal uterine neoplasms and surgery represents the standard treatment. For uterus-limited disease, the remove en bloc with an intact resection of the tumor (without the use of morcellation) is strongly recommended. For advanced-stage disease, the standard surgical treatment is adequate cytoreduction with metastatectomy. Pelvic and para-aortic lymphadenectomy is not recommended in patients with Low-grade Endometrial Stromal Sarcoma (ESS), while is not clear whether cytoreduction of advanced tumors improves patient survival in High-grade ESS. Administration of adjuvant radiotherapy or chemotherapy is not routinely used and its role is still debated.

Endometrial Stromal Sarcoma-Case Report

http://www.ijrrjournal.com/archive\_ijrr\_vol.5\_issue1.html, 2018

Endometrial stromal sarcoma [ESS] is a rare malignant tumour of the endometrium. Usually occurs in perimenopausal women between the age group of 40-50 years. Patients come with symptoms similar to uterine leiomyoma, abnormal vaginal bleeding or abdominal pain, some patients may be asymptomatic. There is a high chance of it to be mistaken for leiomyoma clinically. Although rare, ESS should be kept in mind in women presenting with bulky uterus. A definitive diagnosis can only be made on histopathology. Surgery and postoperative radiotherapy is the most effective treatment.

A retrospective study of endometrial stromal sarcoma (ESS) , An institutional review

Journal of the Pakistan Medical Association, 2020

This is a retrospective study conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore, from January 1995 to April 2016, to determine the clinical presentations, pathological features, cancer free survival and rate of recurrence in patients with Endometrial Stromal Sarcoma (ESS). Data was collected from May to August 2017. A total of 31 patients with a mean age of 40.0±11.72 years were treated. Among them, 12 (38.7%) had stage I, 2 (6.4%) had stage II, 6 (19.3%) had stage III and 11 (35.5%) had stage IV ESS. All patients underwent surgical management as an initial treatment modality for ESS. Out of these 31 patients, 17 were under active surveillance, 4 had expired and 10 patients were lost to follow up. Eleven (65%) patients were disease free, recurrence was noted in 4 (23.5%) patients and 2 (12%) patients had persistent disease. Recurrence of disease was managed with surgical excision and multimodality treatment. Median duration of follow-up was 38.29 months. Endometrial stromal sarcoma (ESS) is a rare uterine tumour. Our patients were young and had lower rate of recurrence. Surgical management was the mainstay of treatment in patients with resectable disease while other options used include d ho rmo nal th era py, radio the ra py or chemotherapy.