Extrapelvic Metastases in Endometrial Stromal Sarcomas: A Clinicopathological Review With Immunohistochemical and Molecular Characterization

2018 ◽  
Vol 27 (2) ◽  
pp. 208-215 ◽  
Author(s):  
Nick Baniak ◽  
Scott Adams ◽  
Cheng-Han Lee ◽  
Rajni Chibbar ◽  
Rani Kanthan
Keyword(s):  
Relevant Literature ◽  
Endometrial Stromal Sarcoma ◽  
Distant Metastases ◽  
Molecular Characteristics ◽  
Prior History ◽  
Diagnostic Challenge ◽  
Original Diagnosis ◽  
Stromal Sarcoma ◽  
Institutional Review ◽  
History Of

Endometrial stromal sarcoma is a rare uterine tumor associated with favorable outcomes despite its ability to recur and metastasize to distant sites. Most recurrences are local, being limited to the abdomen/pelvis, but distant metastases can occur. Metastatic endometrial stromal sarcoma can occur many months to years after the original diagnosis or may present prior to the primary, potentially creating a diagnostic challenge. We report a bi-institutional review of 10 cases of endometrial stromal sarcoma with extrapelvic metastases without a prior history of endometriosis. The histologic, immunophenotypic, and molecular characteristics of these tumors are analyzed in the context of a relevant literature review.

A Clinical and Pathologic Study of 34 Sarcomas of the Uterus

1981 ◽  
Vol 67 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Rado Kenda ◽  
Giuseppe De Palo ◽  
Salvatore Andreola ◽  
Gaetano Bandieramonte ◽  
Giovanni Lupi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Endometrial Stromal Sarcoma ◽  
Controlled Clinical Trials ◽  
Relapse Free Survival ◽  
Histologic Subtype ◽  
Uterine Sarcomas ◽  
Free Survival ◽  
Stromal Sarcoma ◽  
Pathologic Features ◽  
History Of

The clinical and pathologic features of 34 uterine sarcomas were studied to determine the natural history of the disease. Sixteen patients had leiomyosarcoma, five mixed mesodermal sarcoma, ten endometrial stromal sarcoma, two carcinosarcoma and one endolymphatic stromal myosis. The patients were treated without an unique protocol. At 3 years the actuarial relapse-free survival was 53.6 %: 68.4 % in stage I-II patients and 22.2 % in stage III-IV patients. As regards the histologic subtype mixed mesodermal sarcomas had the best prognosis; endometrial stromal sarcomas the worst. The necessity of a uniform clinical and histologic classification as well as the importance of controlled clinical trials are pointed out.

Current treatment options in uterine endometrial stromal sarcoma: report of a case and review of the literature

2007 ◽  
Vol 17 (5) ◽  
pp. 957-963 ◽  
Author(s):  
M. Ihnen ◽  
S. Mahner ◽  
F. JÄNICKE ◽  
J. Schwarz
Keyword(s):  
Randomized Trials ◽  
Uterine Cancer ◽  
Treatment Options ◽  
Endometrial Stromal Sarcoma ◽  
Distant Metastases ◽  
Current Treatment ◽  
High Rate ◽  
Endocrine Treatment ◽  
Cochrane Library ◽  
Stromal Sarcoma

Uterine sarcomas are a rare form of uterine cancer. They occur in women from 40 to 60 years and are generally characterized by poor prognosis, a high rate of local recurrence, and distant metastases. Endometrial stromal sarcoma (ESS) accounts for 0.2% of all gynecological malignancies. Forms of possible treatment include surgery, radiotherapy, chemotherapy, and endocrine treatment. Randomized trials analyzing these treatment options are limited due to the rarity of this disease; therefore, a standard therapy could not be established thus far. To present an overview of the current treatment options of ESS, a search of Medline, Embase, and the Cochrane Library was performed and the results concluded. We report the case of a 32-year-old woman who presented with FIGO stage II ESS. Initial treatment with tamoxifen and local perfusion with cisplatin resulted in disease progression and were discontinued. A novel, therapeutic approach using two cycles of combination chemotherapy with doxorubicin and ifosfamide followed by surgery was applied. Five years after surgery, the patient is still in complete remission. Thus, we conclude that although there is no data from randomized trials available, chemotherapy in advanced or metastatic ESS can provide an opportunity for surgical treatment and can lead to long-term remission.

scholarly journals Metastatic Gallbladder Melanoma Presenting as Acute Emphysematous Cholecystitis

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Natalie Hall ◽  
Nicole L. Grenier ◽  
Samir A. Shah ◽  
Richard Gold ◽  
Edward Feller
Keyword(s):  
Malignant Melanoma ◽  
Acute Cholecystitis ◽  
Distant Metastases ◽  
High Potential ◽  
Prior History ◽  
Emphysematous Cholecystitis ◽  
Abdominal Symptoms ◽  
History Of ◽  
Aggressive Tumor

Malignant melanoma is an aggressive tumor with a high potential for distant metastases, including spread to the gallbladder where it represents more than half of all metastases detected at autopsy. Yet, it is rarely symptomatic in life and is a rare cause of acute cholecystitis. Emphysematous cholecystitis is a rare, potentially fatal variant of acute cholecystitis characterized by the presence of gas in the gallbladder lumen or wall. We report a 77-year-old woman with acute emphysematous cholecystitis as the initial feature of recurrent melanoma metastatic to the gallbladder. This exceptional association highlights the need to consider a relapse of malignancy when assessing unexplained abdominal symptoms in any patient with a prior history of melanoma.

scholarly journals Endometrial Stromal Sarcoma Arising in Colorectal Endometriosis: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Qiao Wang ◽  
Xia Zhao ◽  
Ping Han
Keyword(s):  
Differential Diagnosis ◽  
English Literature ◽  
Tumor Resection ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
Review Of The Literature ◽  
Primary Tumors ◽  
Colorectal Endometriosis ◽  
Stromal Sarcoma ◽  
History Of

Extrauterine endometrial stromal sarcoma (ESS) arising in endometriosis is extremely rare, particularly in the colorectum. It should always be included in the differential diagnosis of primary tumors originating from gastrointestinal tract in females, given that preoperative endoscopical biopsy may reveal no specific changes. We reported a case of ESS arising in colorectal endometriosis and reviewed the previous 7 cases reported in the English literature. Our patient, who was unavailable for tumor resection and refused further adjuvant therapy, played a role in representing the natural history of low-grade extragenital ESS. This case was the only death from ESS arising in colorectal endometriosis.

scholarly journals Subclinical imaging changes in cerebral cavernous angiomas during prospective surveillance

2020 ◽  
pp. 1-8
Author(s):  
Julián Carrión-Penagos ◽  
Hussein A. Zeineddine ◽  
Sean P. Polster ◽  
Romuald Girard ◽  
Seán B. Lyne ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Maximum Diameter ◽  
Prior History ◽  
Study Cohort ◽  
Prospective Surveillance ◽  
Cavernous Angiomas ◽  
Surrogate Outcome ◽  
Institutional Review ◽  
History Of

OBJECTIVEThe purpose of this study was to systematically assess asymptomatic changes (ACs), including subclinical hemorrhage, growth, or new lesion formation (NLF) during longitudinal follow-up of cerebral cavernous angiomas (CAs), and to correlate these with symptomatic hemorrhage (SH) during the same period and with clinical features of the disease.METHODSOne hundred ninety-two patients were included in this study, among 327 consecutive patients with CA, prospectively identified between September 2009 and February 2019. Included patients had undergone clinical and MRI follow-up, in conjunction with institutional review board–approved biomarker studies, and harbored ≥ 1 CA with a maximum diameter of ≥ 5 mm on T2-weighted MRI. Rates of AC and SH per lesion-year and patient-year were assessed using prospectively articulated criteria. In multifocal/familial cases, rates of NLF were also assessed.RESULTSThere were no differences in demographic or disease features among cases included or excluded in the study cohort, except for a higher proportion of included patients with CCM3 mutation. Follow-up was 411 patient-years (2503 lesion-years). The rate of AC was higher than the rate of SH (12.9% vs 7.5% per patient-year, and 2.1% vs 1.2% per lesion-year, both p = 0.02). Patients presenting with a prior history of SH had a higher rate of AC than those with other forms of presentation (19.7% and 8.2% per patient-year, respectively; p = 0.003). A higher rate of NLF on T2-weighted MRI (p = 0.03) was observed in patients with prior SH. Three of 6 solitary/sporadic and 2 of 28 multifocal/familial patients underwent resection of the lesion after AC.CONCLUSIONSRates of AC are greater than SH during prospective follow-up of CAs, and greater in cases with prior SH. AC may be a more sensitive biomarker of lesional activity, and a more efficient surrogate outcome in clinical trials than SH. Patients experiencing an AC are more likely to undergo a surgical intervention when CAs are solitary/sporadic than when they are multifocal/familial.

A ruptured ovarian cystadenofibroma presenting with life-threatening sepsis and an incidental synchronous endometrial stromal sarcoma

2021 ◽  
Vol 14 (11) ◽  
pp. e245473
Author(s):  
Alistair Boyd ◽  
Hemant Sheth ◽  
Faris Kubba ◽  
Mohammad Aziz
Keyword(s):  
Rare Complication ◽  
Iliac Fossa ◽  
Endometrial Stromal Sarcoma ◽  
Uterine Sarcoma ◽  
Stromal Sarcoma ◽  
Gene Testing ◽  
Uterine Neoplasm ◽  
Life Threatening ◽  
History Of ◽  
The Right

A woman in her 60s presented with a rare complication of an ovarian cyst which many clinicians may not consider at first presentation. She was admitted with life-threatening staphylococcus aureus sepsis. She presented shocked with a collapse following a 2-day history of diarrhoea, vomiting and pain in the right iliac fossa. She was taken to theatre where a ruptured, widely infarcted left ovarian serous cystadenofibroma was discovered with over 2 litres of purulent fluid exuding from the cyst into the abdomen. She had a left cyst removal, hysterectomy and bilateral salpingo-oophorectomy performed. Histological analysis and molecular gene testing of an incidentally discovered uterine neoplasm revealed an undifferentiated uterine sarcoma. She successfully recovered as an inpatient and was discharged under the care of an oncology team for ongoing management.

scholarly journals Low grade endometrial stromal sarcoma – A series of 4 cases and review of relevant literature

2015 ◽  
Vol 5 (9) ◽  
pp. 774-777 ◽  
Author(s):  
P Vijayan ◽  
LM Ilias ◽  
A Ponniah ◽  
BA Mohammed
Keyword(s):  
Smooth Muscle ◽  
Light Microscopy ◽  
Relevant Literature ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
Stromal Tumors ◽  
Radiological Features ◽  
Stromal Sarcoma ◽  
Smooth Muscle Tumors ◽  
Endometrial Stromal Tumors

Endometrial stromal tumors are rare uterine malignancies composed of cells resembling those of proliferative endometrial stroma. Because of their indistinct clinical and radiological features, these malignancies are very rarely diagnosed preoperatively. They are mostly often diagnosed as fibroid uteruspreoperatively and as a result managed conservatively many a time. Usually distinguishing these tumors from benign smooth muscle tumors of the uterus are not problematic by light microscopy, however, difficulties arise in distinction between highly cellular leiomyomas and endometrial stromal sarcomas with smooth muscle differentiation. Here we present four consecutive cases of low grade endometrial stromal sarcomaswith emphasis on their clinical, histopathological and immunohistochemical features. By this study, we have attempted to document the histologic features of LGESS with discussion of the differential diagnoses to contribute to this rare spectrum of uterine neoplasms.Journal of Pathology of Nepal (2015) Vol. 5, 774-777

Ultrasound-Guided Transthoracic Fine-Needle Aspiration: A Reliable Tool in Diagnosis and Molecular Profiling of Lung Masses

2019 ◽  
Vol 64 (3) ◽  
pp. 208-215 ◽  
Author(s):  
Erika F. Rodriguez ◽  
Ricardo Pastorello ◽  
Lais Osmani ◽  
Mark Hopkins ◽  
Maria Kryatova ◽  
...  
Keyword(s):  
Molecular Genetic ◽  
Needle Aspiration ◽  
Pulmonary Adenocarcinoma ◽  
Prior History ◽  
Reliable Technique ◽  
Institutional Review ◽  
Stage Disease ◽  
History Of ◽  
Treatment Plans ◽  
Mean Size

Introduction: Pulmonary adenocarcinoma is a major cause of mortality worldwide. The majority of patients present with advanced stage disease, and minimally invasive procedures are desirable for diagnosis and treatment plans. Herein, we report our experience with percutaneous/transthoracic needle aspiration (TT-NA) in the cytologic diagnosis of pulmonary adenocarcinoma. Material and Methods: After institutional review board approval, the cytopathology electronic data system was searched for all consecutive TT-NA of the lung masses from January 2011 to November 2015. Patients’ medical records were reviewed and cytologic materials were evaluated. Results: A total of 151 specimens were identified, with a mean age of 62.8 years; 62.9% of the patients had a prior history of malignancy. Carcinoma/adenocarcinoma was the most common (80%) diagnosis. The targeted lesions were predominantly located in the lung (56.3%, 81/151) and pleural based (27.8%, 42/151). The mean size of the lesions was 3.6 cm. Cytology specimens were adequate in 70.9% of the cases, while 72.8% (110/151) of the cases also had concurrent core biopsy. A malignant diagnosis was rendered in the majority of the cases (64.9%). In 71% of the cases, immunohistochemistry/histochemistry studies were successfully performed. Molecular/genetic studies were requested in 80% of the cases and had adequate material. Complications of the procedure were seen in 9.9% of the patients including pneumothorax (7.9%) and hemoptysis (1.9%). Conclusion: TT-NA is a relatively safe and reliable technique in the assessment of pulmonary lesions.

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