Endometrial Stromal Sarcoma: An Atypical Presentation

Madhumalarmaran, Ponnmalarjanani; Ramachandran, Amrutha; Ahamedkhan, Naseema Beevi; Pillay, R. A.; Nair, Atmaja; Subramaniam, Sooraj; Guhan, Beena

doi:10.1007/s40944-020-00388-6

Cited by 1 publication

(2 citation statements)

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“…LG-ESSs demonstrate strong expression with ERα ( Figure 3 B) [ 54 , 56 , 57 , 58 , 61 , 64 , 65 , 66 , 67 , 68 ], while ER-beta (ERβ) expression is mainly negative with occasional reported cases showing weak positivity [ 64 ]. PR expression positivity has been reported in the majority of cases (>70%), with strong positivity observed in >50% of cases [ 58 , 64 , 69 , 70 ] and its positivity is part of the immunohistochemical confirmation of the diagnosis of LG-ESS [ 54 , 56 , 61 , 65 , 66 , 67 ].…”

Section: Endometrial Stromal Nodule (Esn) and Low-grade Endometriamentioning

confidence: 99%

“…However, in some cases, Cyclin D1 can be positive in the LG-ESS, but with concomitant strong ER and PR positivity and focal CD10 expression, which is unusual in high-grade endometrial stromal sarcoma [ 68 , 74 ]. The Ki67 proliferation index is usually low and has been reported to be positive in ~5–20% of the lesional cells [ 54 , 68 , 73 , 74 ]. It is worth mentioning that Ki67 can vary between tumours found in the same uterine specimen.…”

Section: Endometrial Stromal Nodule (Esn) and Low-grade Endometriamentioning

confidence: 99%

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Update on Endometrial Stromal Tumours of the Uterus

2021

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Endometrial stromal tumours (ESTs) are rare, intriguing uterine mesenchymal neoplasms with variegated histopathological, immunohistochemical and molecular characteristics. Morphologically, ESTs resemble endometrial stromal cells in the proliferative phase of the menstrual cycle. In 1966 Norris and Taylor classified ESTs into benign and malignant categories according to the mitotic count. In the most recent classification by the WHO (2020), ESTs have been divided into four categories: Endometrial Stromal Nodules (ESNs), Low-Grade Endometrial Stromal Sarcomas (LG-ESSs), High-Grade Endometrial Stromal Sarcomas (HG-ESSs) and Undifferentiated Uterine Sarcomas (UUSs). ESNs are clinically benign. LG-ESSs are tumours of low malignant potential, often with indolent clinical behaviour, with some cases presented with a late recurrence after hysterectomy. HG-ESSs are tumours of high malignant potential with more aggressive clinical outcome. UUSs show high-grade morphological features with very aggressive clinical behavior. With the advent of molecular techniques, the morphological classification of ESTs can be integrated with molecular findings in enhanced classification of these tumours. In the future, the morphological and immunohistochemical features correlated with molecular categorisation of ESTs, will become a robust means to plan therapeutic decisions, especially in recurrences and metastatic disease. In this review, we summarise the morphological, immunohistochemical and molecular features of ESTs with particular reference to the most recent molecular findings.

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