I t is an unusual tumour in its behaviour and has been given a variety of names of which 'endometrial stromal sarcoma' seems the most appropriate. This case is presented to record the unique behaviour of a pulmonary metastasis.
CASE REPORTAn English housewife, aged 40 years, was first seen in March, 1956, with a history of intermenstrual bleeding for the preceding 18 months. This had started as a 'show' in mid-cycle and gradually increased in duration and quantity until it continued throughout the cycle. The menarche had been at 13 years and the menstrual cycle was regular. There was no history of previous illness and the obstetric history comprised three normal pregnancies, the last in 1949, and one abortion. On examination the uterus was enlarged and palpable abdominally just above the pubis. A diagnosis of fibroids was made.Total hysterectomy was performed a month later. Enlargement of the uterus was the only abnormality found at operation and the ovaries, which appeared normal, were conserved. The uterus was opened after removal and was found to contain numerous gelatinous polyps and a sub-mucous tumour, thought to be a fibroid. The pathologist reported that the utFrus contained a polygonal and spindle-celled sarcoma probably arising in the endometrial stroma' (Fig. I). The myometrium was lined by hyperplastic endometrium in the secretory phase of the cycle. Recovery after the operation was uneventful. A radiograph of the chest did not reveal any abnormality. Radiotherapy was suggested but the husband refused to consent to this.
