Die Angioblastomatose des Uterus (sog. Stromaendometriose)

Immunocytochemical study of an endometrial diffuse clear cell stromal sarcoma and other endometrial stromal sarcomas

Intermediate filament composition was studied in the following endometrial stromal tumors: low-grade stromal sarcoma (endolymphatic stromal myosis), high-grade stromal sarcoma with an associated adenocarcinoma (collision tumor), diffuse clear cell stromal sarcoma and a mesodermal mixed tumor (carcinosarcoma). The tumor cells of the stromal tumors as well as the mesenchymal elements of the mixed mesodermal tumor were decorated exclusively with antibodies to vimentin. Desmin was not demonstrated in these tumor cells. A biochemical study of the cytoskeletal filaments present in the low-grade stromal sarcoma revealed, in addition to vimentin, beta and gamma actin as seen in normal endometrial stroma. Cytokeratins were only identified in epithelial components which were present in some of these tumors. Intermediate filament typing in these endometrial neoplasms contributes to the elucidation of histogenetic problems, may delineate mesenchymal from epithelial elements, may separate muscle from stromal lesions and in one instance helped to define a hitherto unreported diffuse clear cell stromal sarcoma.

[The stromal and myogenic sarcomas of the uterus (author's transl)]

Stromal sarcomas of the uterus generally originate as homologous tumors from endometrial stromal cells with fixed potentialities. They may be composed of one type of cell or of several types, or rarely they may consist only of endometrial granulocytes. From the same source but with a more favorable prognosis is endolymphatic stromatosis, which arises primarily in the myometrium but does not diffusely invade it, as the stromal sarcoma does. By contrast, heterologous malignant mesenchymal mixed tumors of the endometrium originate from Müllerian epithelium derived fro the mesoderm, and are therefore pluripotential. In this group we find rhabdomyosarcomas and chondroblastomas which have a very poor prognosis. The myogenic sarcomas are three times more common, and arise from smooth muscle cells of the myometrium or its blood vessels. The degree of nuclear pleomorphism may vary considerably, from normal to giant cell types, and may differentiate also as clear-cell myoblasts. They portend a somewhat more favorable prognosis than the stromal sarcomas.

Endolymphatic stromal myosis with autoradiographic observation

A biopsy case of endolymphatic stromal myosis, a rare neoplasm of the uterus, which occurred in a 33-year-old female was described. The histology was typical and resembled stromal cells of proliferative phase endometrium. The tumor extended in the endometrium and diffusely infiltrated into the myometrium and the parametrium. However, 3H-thymidine labeling index was low suggesting slow growth of the tumor.

Endolymphatic stromal myosis: report of a case treated surgically and with hormones

Stromal endolymphatic myosis is regarded as a mixed homologous tumour with a prominent proliferation of the stroma and a varying degree of proliferation of glandlike structures and vessels. A case is presented in which the patient was treated periodically with progestine. This therapy seems to have been of benefit in controlling the frequency of recurrence.