scholarly journals ENDOMETRIAL STROMAL SARCOMA PADA SERVIKS UTERI

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Poppy M. Lintong ◽  
Meilany F. Durry
Keyword(s):  
Abdominal Pain ◽  
Uterine Cervix ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Uterine Cavity ◽  
Endometrial Stromal Sarcoma ◽  
Pelvic Cavity ◽  
Stromal Sarcoma ◽  
Uterine Tumors ◽  
Exophytic Tumor

Abstract: Endometrial stromal sarcoma (ESS) is a rare malignant tumor, about 0.2% of all malignant uterine tumors. Around 75% of ESS cases occur in females under 50 years, with clinical signs such as abdominal pain and bleeding per vaginam. The uterus usually enlarges, associated with polypoid tumors protruding into the uterine cavity which can be misdiagnosed with a leiomyoma. ESS occurs in the cervix, ovarium, or retroperitoneal areas, and can be derived from endometriosis in the pelvic cavity. The immunohistochemical test of the tumor cells is positive for CD10, which is typical to differ it from a leiomyoma. We reported a case of ESS in a woman of 43 years old, with a clinical diagnosis of myoma geburt. She complained of abdominal pain and a mass that came out of her vagina. Post operation, she was diagnosed as having a cervical myoma. The macroscopic examination showed enlargement of uterus tissues 15x6x7 cm, thickened endometrium, and an exophytic tumor mass (8 cm) in the cervix, with cystic and necrotic parts in it. The microscopic examination showed endometrium hypertrophy in secretion phase, cervix with endometriosis, and ESS. ESS in uterine cervix is a rare case, and in this case it is related to endometriosis in the uterine cervix. Conclusion: This case was diagnosed as endometrial stromal sarcoma in the uterine cervix based on anamnesis, physical examination, histopathological examination, and immunohistochemistry positive for CD10.Keywords: endometrial stromal sarcoma, endometriosis, uterine cervixAbstrak: Endometrial stromal sarcoma (ESS) merupakan tumor ganas yang jarang terjadi, hanya 0,2 % dari semua tumor ganas di uterus. Sekitar 75% kasus terjadi pada wanita usia di bawah 50 tahun dengan gejala klinis nyeri perut dan perdarahan melalui jalan lahir. Uterus biasanya membesar disertai tumor polipoid menonjol dalam rongga uterus dan bisa disalah diagnosis sebagai leiomioma. ESS dapat terjadi juga di serviks uteri, ovarium, retroperitoneal, dan di rongga pelvis; dapat berasal dari endometriosis. Pemeriksaan imunohistokimia dari sel-sel tumor ESS yaitu positif untuk CD10, merupakan petanda tipikal untuk membedakannya dari leiomioma. Kami melaporkan kasus ESS pada seorang wanita berusia 43 tahun dengan keluhan nyeri perut dan adanya massa jaringan yang keluar dari jalan lahir. Diagnosis klinis ialah mioma geburt dan pasca operasi diduga sebagai mioma servikal. Pemeriksaan makroskopik menunjukkan jaringan uterus membesar berukuran 15x6x7 cm, dan pada serviks terdapat massa tumor berukuran 8 cm eksofitik, dengan fokus kistik dan nekrotik. Hasil pemeriksaan mikroskopik menunjukkan serviks dengan endometriosis dan ESS. Pemeriksaan imunohistokimia positif untuk CD10. ESS pada serviks uteri merupakan kasus jarang yang berkembang dari endometriosis serviks uteri. Simpulan: Pada kasus ini diagnosis ESS pada serviks uterus ditegakkan berdasarkan anamnesis, pemeriksaan klinis, pemeriksaan histopatlogik, dan imunohistokimia CD10 positif.Kata kunci: endometrial stromal sarcoma, endometriosis, serviks uteri

scholarly journals Disseminated Endometriosis and Low-Grade Endometrioid Stromal Sarcoma in a Patient with a History of Uterine Morcellation for Adenomyosis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Daniel P. Stefanko ◽  
Ramez Eskander ◽  
Omonigho Aisagbonhi
Keyword(s):  
Uterine Cavity ◽  
Endometrial Stromal Sarcoma ◽  
Unintended Consequence ◽  
Low Grade ◽  
Shared Decision ◽  
Patient Counseling ◽  
Stromal Sarcoma ◽  
Uterine Tumors ◽  
History Of ◽  
Pathologic Processes

Morcellation of benign uterine tumors allows for removal of the tumors via minimally invasive laparoscopic procedures. However, in rare cases, morcellation has been associated with upstaging of unexpected malignancies. Morcellation has also been associated with dissemination of benign pathologic processes such as endometriosis and leiomyomas. Endometrial stromal sarcoma typically arises in the uterine cavity, although cases of extrauterine endometrioid stromal sarcoma arising out of foci of endometriosis have been reported. Dissemination of endometrial stromal sarcomas can be an unintended consequence of morcellation procedures, as can dissemination of endometriosis, from which endometrioid stromal sarcomas can arise. Herein, we report a case of a 55-year-old woman who was found to have disseminated endometriosis and low-grade endometrioid stromal sarcoma, with bowel and liver parenchymal metastasis, 7 years after undergoing supracervical hysterectomy with unconfined uterine morcellation for adenomyosis. Our case highlights the potential for malignant transformation of disseminated adenomyosis/endometriosis and the importance of patient counseling and shared decision-making prior to morcellation procedures.

scholarly journals Fusion genes in gynecologic tumors: the occurrence, molecular mechanism and prospect for therapy

2021 ◽  
Vol 12 (8) ◽  
Author(s):  
Bingfeng Lu ◽  
Ruqi Jiang ◽  
Bumin Xie ◽  
Wu Wu ◽  
Yang Zhao
Keyword(s):  
Tumor Progression ◽  
Massively Parallel Sequencing ◽  
Gynecologic Cancer ◽  
Endometrial Stromal Sarcoma ◽  
Driver Mutations ◽  
Fusion Genes ◽  
Stromal Sarcoma ◽  
Uterine Tumors ◽  
Rearrangement Mechanism ◽  
Gynecologic Tumors

AbstractGene fusions are thought to be driver mutations in multiple cancers and are an important factor for poor patient prognosis. Most of them appear in specific cancers, thus satisfactory strategies can be developed for the precise treatment of these types of cancer. Currently, there are few targeted drugs to treat gynecologic tumors, and patients with gynecologic cancer often have a poor prognosis because of tumor progression or recurrence. With the application of massively parallel sequencing, a large number of fusion genes have been discovered in gynecologic tumors, and some fusions have been confirmed to be involved in the biological process of tumor progression. To this end, the present article reviews the current research status of all confirmed fusion genes in gynecologic tumors, including their rearrangement mechanism and frequency in ovarian cancer, endometrial cancer, endometrial stromal sarcoma, and other types of uterine tumors. We also describe the mechanisms by which fusion genes are generated and their oncogenic mechanism. Finally, we discuss the prospect of fusion genes as therapeutic targets in gynecologic tumors.

scholarly journals MIGRATION OF THE INTRAUTERINE DEVICE TO THE ABDOMINAL CAVITY

2017 ◽  
Vol 25 (2) ◽  
pp. 247-262
Author(s):  
D. A. Rahmonov ◽  
F. Sh. Rashidov ◽  
E. L. Kalmykov ◽  
M. M. Marizoeva ◽  
O. B. Bobdjonova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intrauterine Device ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Uterine Cavity ◽  
Pain Syndrome ◽  
Pregnant Patient ◽  
Pelvic Cavity ◽  
And Migration ◽  
Laparoscopic Removal

The aim: demonstration of our experience of surgical treatment of patients with migrated intrauterine device (IUD) into the abdominal cavity. The results of surgical treatment of migrated IUDs in the pelvic cavity are summarized in 17 women. The average age of the patients was 33,23,4 years. The timing of implantation of the IUDs varied from 10 days to 24 months. In all cases, the intra operational finding was T-shaped a copper device. The reason behind the women's consultation was an increase in pain syndrome in the lesser pelvis (n=15), dysuric phenomenon (n=1) and the onset of pregnancy (n=1). Perforation of the uterus and migration of the spiral occurred from 10 days to 2 years after its implantation. All patients were operated laparoscopicaly. The average duration of operations was 45,510,5 minutes. In the postoperative period there were no complications from the pelvic organs and postoperative wounds. The period of hospitalization of patients was 3,50,7 days. In all cases there was a regression of clinical signs and recovery. In one pregnant patient (gestation period 5-6 weeks) the pregnancy proceeded without particular pathological abnormalities and resulted in the birth of a full-term child. Laparoscopic removal of the IUD migrating from the uterine cavity to the abdominal cavity is the method of choice in the treatment of this group of patients, avoiding development of intra- and postoperative complications and a shorter length of stay in the hospital. The effectiveness of the procedure reaches 100%. The most common cause of complication of the IUD is the perforation of the uterus during its implantation.

scholarly journals Pleural Metastasis of High-Grade Endometrial Stromal Sarcoma With YWHAE Gene (17p13.3) Rearrangement, A Rare Case Report

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S41-S41
Author(s):  
A C Re ◽  
M Enrique ◽  
S Ren
Keyword(s):  
Case Report ◽  
Spindle Cell ◽  
Malignant Neoplasm ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
High Grade ◽  
Stromal Sarcoma ◽  
Uterine Tumors ◽  
Uterine Neoplasm ◽  
Left Pleural Effusion

Abstract Introduction/Objective Endometrial stromal sarcoma (ESS), a rare malignant neoplasm of endometrial stroma, accounts for less than 1% of all uterine tumors. High grade ESS (HGESS) is aggressive and commonly relapses even after surgical and neoadjuvant therapy. Abdominal and pelvic regions are common sites of metastasis, however, distant metastases to the liver, lung, vertebrae, and brain have been reported. Methods/Case Report We encountered a 49-year-old female who presented with shortness of breath, found to have a left pleural effusion and multiple pleural masses. She initially presented three years ago with heavy irregular menses and left pelvic pain for one year. D&C revealed prominent small spindle cells for which a stromal nodule and low-grade or malignant process was probable. CT scan showed an enlarged uterus. Hysterectomy with bilateral salpingo- oophorectomy, bilateral pelvic and para-aortic lymph node dissection, and partial omentectomy were performed. The uterus revealed an intramural 7 cm mass with a serpiginous growth pattern and lymphovascular invasion. Tumor cells were plump to spindled with areas of high cellularity, rounded nuclei, increased atypia and mitosis. Atypical areas were positive for cyclin D1, focally positive for CD10, and negative for ER, PR, SMA, desmin, AE1/3 and CAM5.2. FISH studies showed rearrangement of YWHAE gene (17p13.3) and no rearrangement of JAZF1 or PHF1 gene regions. Findings supported the diagnosis of HGESS. The patient received post-operative chemotherapy. Biopsy of the current pleural lesion revealed a nonspecific malignant spindle cell neoplasm positive for BCL1, CD56, CD117, CD99, TLE1 and INI1, while negative for AE1/3, CAM5.2, EMA, ER, PR, CK5/6, calretinin, SMA, desmin and S100. The CD10 stain was inconclusive. FISH studies showed rearrangement of YWHAE gene (17p13.3) and no rearrangement involving JAZF1 or PHF1 gene regions. No rearrangement of the SS18 gene region was observed and synovial sarcoma was excluded. Overall findings support the diagnosis of metastatic HGESS. Results (if a Case Study enter NA) NA Conclusion HGESS, a rare tumor with a nonspecific immunostain profile, has the ability to metastasize to rare body sites, such as the pleura in our case. Display of spindle cell morphology is a nonspecific finding that raises broad differential diagnoses. In women, with or without a history of uterine neoplasm, HGESS is a clinically worthwhile diagnosis to be mindful of.

scholarly journals A study of correlation between clinical, radiological and pathological diagnosis of appendicitis: a retrospective analytic study

2018 ◽  
Vol 5 (9) ◽  
pp. 3011
Author(s):  
Prabhu R. ◽  
Vijayakumar C. ◽  
Balagurunathan K. ◽  
Senthil Velan M. ◽  
Kalaiarasi R. ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Scoring System ◽  
Acute Abdominal Pain ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Radiological Finding ◽  
Clinical Signs ◽  
Emergency Setting ◽  
Alvarado Score

Background: Acute appendicitis is the most common cause of acute abdominal pain in young adults requiring emergency surgery. Appendicectomy is the most frequently performed surgery. The diagnosis is often challenging and the decision to operate in an emergency setting is always debatable. A combination of clinical signs and symptoms with laboratory findings in many scoring systems are suggesting the probability of appendicitis and the possible subsequent management pathway. The aim was to evaluate accuracy of the clinical Alvarado scoring system, radiological finding and histopathological examination for the diagnosis of acute appendicitis.Methods: A retrospective study was conducted in the department of general surgery in a tertiary care centre in South India. Total of 237 patients with acute abdominal pain were included and evaluated with the clinical Alvarado scoring system, radiological finding with (USG/CT abdomen) and histopathological examination for the diagnosis of acute appendicitis. The data was collected and analyzed retrospectively.Results: Of the 237 patients, 164 patients were male (69.1%) and rest is female. The correlation of the Alvaroda score with histopathological findings in groups with score > 7 and ≤7 the correlation of Alvarado score and the ultrasound findings were comparable between the study groups. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score >7 was 72.99%. The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score ≤7 was decreased to 27%.Conclusions: The diagnostic accuracy of clinical features is far better than radiological investigations in the diagnosis of acute appendicitis. Therefore, it is concluded that it is better to use radiological investigations only to confirm the diagnosis of acute appendicitis rather to diagnose it.

scholarly journals Laparoscopic management of endometrial stromal sarcoma in young: a case report

2020 ◽  
Vol 9 (5) ◽  
pp. 2144
Author(s):  
Shailesh Puntambekar ◽  
Shetty Theertha Shankar ◽  
Arjun Goel ◽  
Shakti Panchal
Keyword(s):  
Clinical Course ◽  
Histopathological Examination ◽  
Endometrial Stromal Sarcoma ◽  
Initial Therapy ◽  
Uterine Sarcoma ◽  
Low Grade ◽  
Lower Abdomen ◽  
Uterine Sarcomas ◽  
Stromal Sarcoma ◽  
Locally Recurrent

Endometrial stromal sarcoma (ESS) is a case malignancy and accounts for 0.2% of all uterine malignancies and 10% of all uterine sarcomas. In the present case, an unmarried 27-year-old woman presented with complaints of on and off episodes of pain in the lower abdomen. On examination, a diffuse oval mass was felt occupying the hypogastrium, iliac and lumbar regions and extending up to the umbilicus. CT scan impression was given as? Complex retroperitoneal mass? solid cystic ovarian mass with grade I right hydro nephrosis. On laparoscopy, a huge mass measuring approximately 10×10 cm was noted arising from the uterus. Laparoscopic myomectomy was done and the specimen was retrieved in a bag and the tissue was sent for histopathological examination. The postoperative clinical course was uneventful. The patient was advised to undergo oocyte cryopreservation following which she was advised hysterectomy with bilateral salphingo-oophorectomy. Pelvic radiation was advised thereafter. ESS is a rare malignant tumor, which on histopathological examination reveals sheets of cells and endometrial stromal cell differentiation. Hysterectomy with bilateral salpingo-oophorectomy is optimum initial therapy. Radiotherapy is chosen when the tumour is inadequately excised or the pelvic disease is locally recurrent. Low grade ESS is a rare form of uterine sarcoma usually seen between 40-60 years of age with limited available data regarding the clinical course and management. Early diagnosis and management is associated with a favourable prognosis and outcome.

scholarly journals Tissue Extraction and Morcellation: The Menace of Unexpected Malignancy

2017 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Khulkar Abdusattarova
Keyword(s):  
Uterine Fibroid ◽  
Histopathological Examination ◽  
Uterine Fibroids ◽  
Endometrial Stromal Sarcoma ◽  
Uterine Sarcoma ◽  
Preoperative Imaging ◽  
Tissue Extraction ◽  
Stromal Sarcoma ◽  
Power Morcellation ◽  
Symptomatic Uterine Fibroid

ABSTRACT Uterine fibroids are a common indication for hysterectomy or myomectomy. Even with optimal preoperative imaging, unexpected uterine sarcoma can be detected in histopathology after uterine fibroid surgery. In case of inadvertent morcellation of an unexpected uterine sarcoma the clinical outcomes, due to the rapid intraperitoneal dissemination of malignant tissue during the procedure can be negatively influenced. The purpose of this study was to determine the prevalence of uterine sarcoma in women undergoing hysterectomy or myomectomy for benign uterine fibroids. We performed retrospective study (2003-2014 years). The total number of women operated for uterine fibroids was 2297. Of this, 938 (42.5%) women had myomectomies and 1269 (57.5%) women had hysterectomies. In myomectomies the most frequently used surgical method was laparoscopic myomectomy in 591(63%) cases, followed by hysteroscopy myomectomy in 306 (32.62%) cases, and laparotomic myomectomy only in 41 (4.37%) cases. In hysterectomies, laparoscopic approaches significantly dominated in 1163 (61.1%) cases, showing laparotomic approaches in 491(25.82%) cases and vaginal approaches in 247 (12.99) cases. Only one patient with endometrial stromal sarcoma (ESS) was not preoperatively diagnosed and treated as symptomatic uterine fibroid; this patient underwent laparoscopic supracervical hysterectomy. In the post-operative histopathological examination ESS was detected. Thus, our incidence of sarcomas among women who underwent benign uterine fibroid surgery is 1/2297 (0,043%). Laparoscopic power morcellation should be performed only in cases with no suspicion of malignancy Patients, who undergo laparoscopic surgery with power morcellation should be informed about the possible risks of morcellation in cases of rare not suspected malignant disease. How to cite this article Mettler L, Abdusattarova K. Tissue Extraction and Morcellation: The Menace of Unexpected Malignancy. Int J Gynecol Endsc 2017;1(1):1-4.

scholarly journals A Case Report of High-Grade Endometrial Stromal Sarcoma: A Rare Cause of Abnormal Uterine Bleeding in a Young Woman

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Nuntasiri Eamudomkarn ◽  
Yuwadee Itarat ◽  
Pilaiwan Kleebkaow ◽  
Chumnan Kietpeerakool
Keyword(s):  
Young Women ◽  
Endometrial Stromal Sarcoma ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Cavity ◽  
Rapid Progression ◽  
High Grade ◽  
Excessive Bleeding ◽  
Stromal Sarcoma

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.

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