Isolated ureteral extrauterine endometrial stromal sarcoma: an unusual presentation

2021 ◽  
Vol 14 (9) ◽  
pp. e245099
Author(s):  
Raghavendran Asokan ◽  
Leena Dennis Joseph ◽  
Arthi Mohanendran ◽  
Sriram Krishnamoorthy

Extrauterine endometrial stromal sarcomas (EUESSs) are rare tumours occurring without primary uterine involvement. They are classified as primary or secondary, depending on uterine involvement by stromal sarcomas. A 56-year-old woman who earlier underwent bilateral modified radical mastectomy for adenocarcinoma and total abdominal hysterectomy for endometrial stromal sarcoma, followed by tamoxifen therapy, presented with left loin pain. On evaluation, she had a left renal calculus with hydroureteronephrosis. Before percutaneous nephrolithotripsy, ureteroscopy revealed a polypoidal mass that was diagnosed as EUESS. The mass arose primarily within the ureteral lumen, with periureteric tissue uninvolved. She underwent left radical nephroureterectomy with adjuvant hormonal treatment. This is probably the first case of EUESS arising de novo from within the ureteral lumen without endometriosis, to be reported in medical literature. Immunohistochemistry facilitates earlier diagnosis. Cytoreductive surgery is the definitive treatment and multidisciplinary approach helps in overall survival of the patient.

2018 ◽  
Vol 10 (3) ◽  
pp. 133-135
Author(s):  
Jonathan Chapman ◽  
Blake Bartholomew ◽  
Sayf Al-Katib

This article describes a case of endometrial stromal sarcoma arising in a background of endometriosis presenting several years after total abdominal hysterectomy. Discussion of endometrial stromal sarcoma ensues as well as review of pertinent imaging findings.


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Sefa Kelekci ◽  
Serenat Eris ◽  
Emine Demirel ◽  
Serpil Aydogmus ◽  
Nese Ekinci

Uterine lipoleiomyomas are rare benign tumours that are composed of various mixtures of smooth muscle and mature fat tissue. Leiomyomas, which arise primarily in the ovary, are extremely rare tumours that account for 0.5–1% of all benign ovarian tumours. To the best of our knowledge, we present the first case of an ovarian leiomyoma coexisting with a uterine lipoleiomyoma in the postmenopausal period. A 59-year-old, gravida 4, para 3, postmenopausal woman exhibited pelvic discomfort and increased frequency of micturition. A pelvic examination revealed a solid, tender mass on the left side that could not be clearly separated from the uterus. She underwent a laparotomy with an initial diagnosis of a left ovarian mass. She had previously undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy. A histopathological examination revealed a uterine lipoleiomyoma, composed of variable amounts of smooth muscle cells and mature adipocytes and a right ovarian leiomyoma composed of interlacing bundles and fascicles of spindle cells. The coexistence of these two rare entities in the same individual may represent a common pathway as a stimulating agent. This case may help to clarify the pathogenesis of these lesions.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Nuntasiri Eamudomkarn ◽  
Yuwadee Itarat ◽  
Pilaiwan Kleebkaow ◽  
Chumnan Kietpeerakool

High-grade endometrial stromal sarcoma (HG-ESS) is a rare clinical entity, particularly among young women, and only few cases have been reported in the literature. Herein, we describe the case of a 21-year-old woman who presented with a four-month history of excessive bleeding per vagina. Endometrial curettage and cervical biopsy revealed a malignant round cell tumor suggestive of metastatic sarcoma of uterine origin. Computed tomography of the abdominopelvic region showed an enlarged uterus with diffused thickening throughout the entire endometrial cavity. Intraabdominal lymphadenopathy and ascites in the pelvic cavity were noted. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, resections of the enlarged pelvic nodes, omentectomy, and biopsy of the peritoneal nodules in the cul-de-sac. Histological examination revealed a tumor with a permeative growth pattern composed of uniformly high-grade round cells with brisk mitotic activity and extensive lymphovascular space invasion. Sections of the pelvic lymph nodes on both sides and the peritoneal nodule revealed multiple metastatic foci. Immunohistochemical studies showed positive diffuse staining for vimentin, CD 10, and cyclin D1. The pathological diagnosis was HG-ESS stage IIIC. The patient experienced rapid progression of the disease while receiving adjuvant treatment and succumbed eight months after the operation. HG-ESS is a rare cause of AUB in adolescents and young women but should be considered in the differential diagnosis.


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Nisar A. Chowdri ◽  
Asif Mehraj ◽  
Fazl Q. Parray ◽  
Mudassir A. Khan ◽  
Masood A. Laharwal ◽  
...  

Endometrial stromal sarcomas of uterus are quite rare. Most of the recurrences in these tumors are seen in the pelvis. However, extrapelvic recurrences and metastases to other parts are quite unusual. Here, we are reporting a rare case of caecal recurrence of endometrial stromal sarcoma. Case Report. A 52-year-old female presented to us with pain and lump in the right lower abdomen. The patient was earlier subjected to total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAHBSO) for low-grade endometrial stromal sarcoma. Postoperatively patient received radiotherapy but no hormone therapy. After 10 years of follow up patient presented with a polypoidal lesion in the caecum. Patient was evaluated fully and subjected to resection of this polypoidal lesion, which proved out to be high-grade endometrial stromal sarcoma. Conclusion. Recurrence of endometrial stromal sarcoma in the caecum is very rare. However, this entity needs to be kept in mind for differential diagnosis of a caecal mass. Recurrence in such cases may present quite late.


Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Nefertiti Chianti duPont ◽  
Philip John DiSaia

Endometrial stromal sarcoma (ESS) formerly classified as low-grade endometrial stromal sarcoma is a rare uterine malignancy with a good prognosis despite a tendency to recur. Primary surgical management for ESS includes total abdominal hysterectomy and bilateral salpingo-oophorectomy. Patients with ESS have long disease-free survival rates when treated with primary surgical therapy, but nearly fifty percent of these patients will recur. We present the case of a patient with recurrent ESS who had an excellent response to combined therapy with megestrol and leuprolide.


Author(s):  
Poojan Dogra ◽  
Shuchi Sharma ◽  
Reena Sharma ◽  
Suraj Bhardwaj

Uterine sarcomas are relatively rare tumors of mesodermal origin. ESS occurs primarily in perimenopausal women in 4th and 5th decade of their life; about one third occurs in postmenopausal women. Here in we describe a case of 44 years old patient presented with one month history of foul smelling discharge per vagina and a pelvic mass. Ultrasound and MRI gave possibility of a large anterior wall and fundal fibroid with degeneration versus neoplastic endometrial thickening. The patient underwent exploratory laparotomy with total abdominal hysterectomy with bilateral salpingoophorectomy with pelvic lymphadenectomy. Histopathology showed tumor cells with round to oval nuclei with high mitotic activity, blood vessel proliferation between the tumor cells and extensive lymphovascular invasion. The pathological diagnosis was HG-ESS stage IB. The patient was referred to radiotherapy department for adjuvant therapy. HG-ESS is a rare clinical entity and considered as important differential diagnosis.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
F. Z. Fdili Alaoui ◽  
H. Chaara ◽  
H. Bouguern ◽  
M. A. Melhouf ◽  
H. Fatemi ◽  
...  

Endometrial stromal nodule (ESN) is the least common of the endometrial stromal tumors. They are rare neoplasms which are diagnosed in most instances by light microscopy. Although such nodules are benign, hysterectomy has been considered the treatment of choice to determine the margins of the tumor required for diagnosis and to differentiate it from invasive stromal sarcoma Whose prognosis is totally different. We report a case of a 45 years old woman, with presurgical diagnosis of adnexal mass or uterine tumor. She underwent a total abdominal hysterectomy. Pathologic examination revealed an endometrial stromal nodule. Through this observation, we insist on the fact that the ESNs are rare and benign entities which must be differentiated from the other invasive malignant stromal tumors; this can change the final prognosis.


Rare Tumors ◽  
2011 ◽  
Vol 3 (3) ◽  
pp. 86-89 ◽  
Author(s):  
Mary I. Huang ◽  
Robert L. DeBernardo ◽  
Mark Rodgers ◽  
David J. Hart

Endometrial stromal sarcoma (ESS) is typically associated with metastasis to the abdomen, pelvis, and lung. We found three case reports of ESS metastasis to the bone (two to the thoracic spine, and one to the parietal bone). Our objective is to review the literature on ESS spinal and intracranial metastases and, report the first case of ESS metastatic to the lumbar paraspinal region and sphenoid bone. A 53-year-old female with ESS status-post radiation, chemotherapy, and pelvic exenteration surgery presented with right hip weakness, back pain, and radicular leg pain that were explained by chemotherapy-induced neuropathy, radiation-induced lumbosacral plexopathy, and femoral nerve and obturator nerve injury during pelvic exenteration surgery. During routine positron emission tomography, we found metastasis to the L3 lumbar spinal region. L3 laminectomy and subtotal resection of the mass was performed with tumor residual in the neuroforamina and pedicles. One month later, magnetic resonance imaging (MRI) performed for persistent headaches revealed a large lesion in the sphenoid bone that was biopsied transsphenoidally with the same diagnosis, but no further surgery was performed. She is intolerant of chemotherapy and currently undergoing whole brain radiation. Delay in the diagnosis and management of lumbar paraspinal and sphenoid bone metastasis of ESS likely occurred because of the uniqueness of the location and aggressiveness of ESS metastasis. Health care providers should be aware of potentially aggressive metastasis of ESS to bone, in particular the unusual locations of the lumbar paraspinal region and sphenoid bone.


2010 ◽  
Vol 28 (3) ◽  
pp. 771-774 ◽  
Author(s):  
Keiko Shoji ◽  
Katsutoshi Oda ◽  
Shunsuke Nakagawa ◽  
Kei Kawana ◽  
Toshiharu Yasugi ◽  
...  

2021 ◽  
Vol 8 (8) ◽  
pp. 2454
Author(s):  
Abhirup H. R. ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda

BRCA1 and BRCA2, known as breast and ovarian cancer predisposition genes, were discovered in the 1990s. As part of a normal genetic structure, these genes are intrinsic to all human beings, but they are mutated in some individuals increasing the risk for breast and ovarian cancers development. BRCA1 is not only expressed in endocrine tissues but is also detected in other cells such as the neuroepithelial cells in the early stage of cell development. Like BRCA1, BRCA2 is also expressed in a wide variety of tissues and is observed with higher rates in the breast and thymus and with lower rates in the lung, ovary and spleen. We presented to you a case of 40 year old female admitted in surgical ward with lump in the left breast since 2 months with ipsilateral discrete axillary lymphadenopathy. Bilateral sono-mammography showed BIRADS V lesion in left breasts with satellite nodules. Ultrasonography of abdomen and pelvis showed large left adnexal solid mass lesion and right sided ovarian cyst with retrocaval, preaortic lymphadenopathy. Patient underwent a diagnostic laparoscopy which was converted to a laparotomy. Total abdominal hysterectomy with bilateral salphingo-oophorectomy was done. For the breast lump, patient underwent left sided modified radical mastectomy. Gene testing for revealed BRCA1 positivity. Chemotherapy was given to cover both breast and ovarian carcinoma. Patient came back with abdominal distension after 9 months and was offered palliative care. Patient succumbed for disease after 1 year after diagnosis. We reviewed the literature for the same.


Sign in / Sign up

Export Citation Format

Share Document