Hormone therapy and low-grade endometrial stromal sarcoma

Endometrial stromal sarcomas (ESS) account for 10-15% of uterine malignancies and are classified into four categories: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS) and undifferentiated uterine sarcoma (USS). Depending on stage, ESS is treated with surgery, hormone therapy, chemotherapy or targeted therapy. A rare complication of ESS with metastatic pulmonary disease is recurrent, bilateral pneumothoraces. The current literature has reported on patients with ESS who either presented with pneumothoraces at their initial diagnosis, and thus were untreated, or after treatment with surgical resection and hormone therapy. There have been no case reports of patients with ESS who presented with pneumothoraces while receiving chemotherapy. Furthermore, there have been no reported cases of patients with HG-ESS presenting with this rare complication. We would like to expand the literature by reporting on two patients with HG-ESS who presented with pneumothoraces while concurrently receiving chemotherapy.

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Hormone therapy following surgery in low-grade endometrial stromal sarcoma

Journal of the Chinese Medical Association ◽

10.1097/jcma.0000000000000039 ◽

2019 ◽

Vol 82 (5) ◽

pp. 385-389 ◽

Cited By ~ 2

Author(s):

Gunsu Kimyon Comert ◽

Osman Turkmen ◽

Irem Kar ◽

Ozge Yucel ◽

Cigdem Kilic ◽

...

Keyword(s):

Hormone Therapy ◽

Endometrial Stromal Sarcoma ◽

Low Grade ◽

Stromal Sarcoma

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Primary low-grade extrauterine endometrial stromal sarcoma: analysis of 10 cases with a review of the literature

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02474-1 ◽

2022 ◽

Vol 20 (1) ◽

Author(s):

You Wu ◽

Nan Li ◽

Rong Zhang ◽

Ping Bai

Keyword(s):

Hormone Therapy ◽

Tumor Resection ◽

Endometrial Stromal Sarcoma ◽

R0 Resection ◽

Low Grade ◽

Adjuvant Hormone Therapy ◽

Stromal Sarcoma ◽

Initial Surgery ◽

Optimal Tumor

Abstract Background This study aimed to analyze the clinical and pathological features of extrauterine endometrial stromal sarcoma (EESS) and explore an effective therapeutic regimen to reduce the recurrence rate in low-grade EESS patients. Methods Ten LG-EESS patients who were treated at the Chinese Academy of Medical Sciences Cancer Institute and Hospital from June 1999 to June 2019 were collected and analyzed. Results (1) Patient demographics are summarized in manuscript. Preoperative CA125 examination showed that 8 patients had a median level of 49.5 U/L (15.4–168.0 U/L). (2) All ten patients underwent tumor cytoreductive surgery. Five patients underwent optimal tumor resection and achieved an R0 resection. After the initial surgery, 7 patients who had multiple metastasis were treated with adjuvant chemotherapy, 2 patients with vaginal ESS were treated with chemotherapy and radiation therapy, and 6 patients with ER/PR positive received hormone therapy with or without chemotherapy. (2) Most EESS patients had multiple tumors. The omentum was the most commonly affected site, followed by the ovaries. (3) The median follow-up was 94 (range: 27–228) months, and recurrence was observed in 3 patients (n = 10, 30%) who underwent non-optimal surgery and no hormone therapy. The 5-year and 10-year DFS rates were both 70%, as shown in Fig. 2. OS was both 100% at 5 and 10 years. Conclusion As a conclusion, EESS is a rare disease and LG-EESS has a good prognosis. Surgery remains the available treatment for patients. LG-EESS has a risk of late recurrence which requires a long-term follow-up. With a limited sample size, our study shows optimal tumor reductive surgery and adjuvant hormone therapy may significantly reduce the risk of recurrence.

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