Document Type : Case Reports
Authors
1 Department of Pathology, M M Institute of Medical Sciences and Research, M M University, Haryana, India
2 Department of Pharmacology, M M Institute of Medical Sciences and Research, M M University, Haryana, India
Abstract
Endometrial stromal sarcoma represents a very rare pathological entity occurring as a malignant disease in women genital sphere, frequently in the age group of 40-50 years. Low grade endometrial stromal sarcoma (LGESS) is a rare uterine sarcoma constituting 0.2% of all the uterine malignancies with a good prognosis despite a tendency to recur. We report a case of 42 years old woman presented with menorrhagia, dysmenorrhoea, anemia and rapidly enlarging mass in uterus clinically diagnosed as leiomyoma, underwent a hysterectomy. Histological examination revealed cells with ovoid to short, spindle shaped nuclei resembling endometrial stromal cells proliferating in a space occupying manner and compressing and partially infiltrating the myometrium, rendered the diagnosis of LGESS. Our case emphasizes the inevitability for high index of skepticism and proper preoperative diagnosis in this rare tumor.
Keywords
- Boardman CH, Webb MJ, Jefferies JA. Low grade endometrial stromal sarcoma of the ectocervix after therapy for breast cancer. Gynecol oncol 2000;79(1):120-3.
- Policarpio-Nicolas ML, Cathro HP, Kerr SE, Stelow EB. Cytomorphologic features of low-grade endometrial stromal sarcoma. Am J Clin Pathol 2007;128(2):265-71.
- Geetha P, Nair VR, Singh S. Endometrial stromal sarcoma. Indian J Med Paediatr Oncol 2010; 31: 21-23.
- Pink D, Lindner T, Mrozek A, Kretzschmar A, Thuss-Patience PC, Dorkan B, et al. Harm or benefit of hormonal treatment in metastatic in low grade endometrial stromal sarcoma: single centre experience with 10 cases and review of literature. Gynecol Oncol 2006; 101(3):464-9.
- Pandey P, Dixit A, Kaur S. Mixed endometrial stromal tumor with smooth muscle differentiation: a report of two cases. Journal of Clinical and Diagnostic Research [Serial online] 2010;3:2071-5.
- Livi L, Paiar F, Shah N, Blake P, Villanucci A, Amunni G. Uterine sarcoma: twenty-seven years of experience. Int J Radiat Oncol Biol Phys 2003; 57(5):1366-73.
- Kim L, Choi SJ, Park IS, Han JY, Kim JM, Chu YC, et al. Endometrial stromal sarcoma of the small bowel. Ann Diagn Pathol 2008;12(2):128-33.
- Kurman RJ. Blaustein’s pathology of the female genital tract. New Delhi:Thomson; 2004.
- Baker P, Oliva E. Endometrial stromal tumors of the uterus: A practical approach using conventional morphology and ancillary techniques. J Clin Pathol 2007;60(3):235-43.
- Bhargava R, Shia J, Hummer AJ, Thaler HT, Tornos C, Soslow RA. Distinction of endometrial stromal sarcomas from hemangiopericytomatous tumors using a panel of immunohistochemical stains. Mod Pathol 2005;18(1):40-7.
- Clement PB, Young RH, Scully RE. Intravenous leiomyomatosis of the uterus. A Clinicopathological analysis of 16 cases with unusual histologic features. Am J Surg Pathol 1988;12(12):932-45.
- Oliva E. CD10 expression in the female genital tract: does it have useful diagnostic applications? Adv Anat Pathol 2004;11(6):310-15.
- Folpe AL, Mentzel T, Lehr HA, Fisher C, Balzer BL, Weiss SW. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol 2005; 29(12):1558-75.
- Linder T, Pink D, Kretzschmar A, Mrozek A, Patience PC, Reichardt P. Hormone treatment of endometrial stromal sarcomas: a possible indication for aromatase inhibitors. J Clin Oncol 2005;23:16s:9057.
- Husseiny GE, Bareedy NA, Mourad WA, Mohamed G, Shoukri M, Subhi J. Prognostic factors and treatment modalities in uterine sarcoma. Am J Clin Oncol 2002; 25(3):256-60.
- Rovirosa A, Ascaso, Ordi J, Abellana, Arenas M, Lejarcegui JA, et al. is vascular and lymphatic space invasion a main prognostic factor in uterine neoplasms with a sarcomatous component? A retrospective study of prognostic factors of 60 patients stratified by stages. Int J Radiat Oncol Biol Phys 2002;52(5):1320-9.
)