Metastatic low-grade endometrial stromal sarcoma with sex cord and smooth muscle differentiation: A case report

Abstract

BACKGROUND Metastatic low-grade endometrial stromal sarcoma (LG-ESS) with sex cord-like and smooth muscle-like differentiation is rare. This article reports such a case with multiple recurrences and with extensive pelvic and abdominal metastasis. CASE SUMMARY A 47-year-old female patient was diagnosed with multiple cystic masses in the pelvic cavity by magnetic resonance imaging examination. Based on the postoperative pathological and immunohistochemical analyses of the surgical specimen, she was diagnosed with a metastatic low-grade endometrial stromal sarcoma with sex cord and smooth muscle differentiation. CONCLUSION LG-ESS is a low-grade malignant tumor with a high recurrence rate and metastasis probability. It is easily misdiagnosed initially. It is essential to distinguish LG-ESS with sex cord-like differentiation from uterine tumour resembling ovarian sex cord tumour.

Utero-ovarian low grade endometrial stromal sarcoma, a case report

“…LG-ESS is a rare malignant mesenchymal neoplasm consists of cells like proliferative phase of endometrial cells [10] . LG-ESS consists 0.2 % of all gynecological system malignancies with a yearly incidence of 2 per million women all over the world [11] , [12] . Most common age in Low-grade endometrial stromal sarcoma (LG-ESS) is often between 42 and 58 years old.…”

Unusual morphologic features of low‐grade endometrial stromal sarcoma: A case report

“…1 The tumour is usually 1-25 cm in size, with an average value of 8-11 cm. 3 Risk factors for the tumour includes obesity, diabetes, younger age at menarche, tamoxifen intake or oestrogen use and pelvic radiation. 4,5 In our young patient, the tumour grew rapidly from 2 to 10 cm in maximum diameter.…”

“…It occurs most frequently in women of perimenopausal age 1 . The tumour is usually 1–25 cm in size, with an average value of 8–11 cm 3 . Risk factors for the tumour includes obesity, diabetes, younger age at menarche, tamoxifen intake or oestrogen use and pelvic radiation 4,5 .…”

Extragenital endometrial stromal sarcoma of transverse mesocolon: A diagnostic conundrum

“…17 Tumors with sex-cord stromal differentiation may also show SMA reactivity, consistent with an epithelial-myoid phenotype of some sex cord elements in ESS. 20 ESS is typically negative for CD34.…”