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Sim YB, Baek JK, Seo SK. Extrauterine Undifferentiated Uterine Sarcoma Arising from Bladder Endometriosis in a Postmenopausal Woman: A Case Report. J Menopausal Med 2023; 29:139-142. [PMID: 38230598 PMCID: PMC10796200 DOI: 10.6118/jmm.23030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024] Open
Abstract
Endometriosis (EMS) is a rare condition in postmenopausal women. The incidence of transition from EMS to malignancy is as low as 1%, with endometrial stromal tumors (ESTs) occurring at an even lower incidence of 0.7%. Undifferentiated uterine sarcomas (UUSs) are a subtype of ESTs that account for 25% of all ESTs. Extrauterine UUSs are exceptionally rare, with only a few reported cases in the literature. We present the case of a woman who underwent surgery for deep infiltrating EMS and was later diagnosed with UUS, which originated from the bladder after surgical menopause.
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Affiliation(s)
- Ye Bin Sim
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Kyung Baek
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Kyo Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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2
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Extrauterine endometrial stromal sarcoma: A systematic review and outcome analysis. Ann Diagn Pathol 2022; 59:151966. [DOI: 10.1016/j.anndiagpath.2022.151966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 11/18/2022]
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3
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Manjula C, Beluru VS, Raju BH, Simon N. Primary low-grade extrauterine endometrial stromal sarcoma with sex cord elements involving the omentum: A case report with review of literature. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2022. [DOI: 10.4103/amhs.amhs_6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4
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Sharma A, Bal M, Menon S. Extragenital endometrial stromal sarcoma of transverse mesocolon: A diagnostic conundrum. Int J Surg Pathol 2021; 30:551-556. [PMID: 34970922 DOI: 10.1177/10668969211070485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Endometrial stromal sarcoma (ESS) is a rare uterine neoplasm infrequently arising in extra-genital sites. Herein, we report an extremely rare case of primary extra-genital ESS of transverse mesocolon occurring in a 51-year-old female presenting with gradually increasing abdominal mass. The clinical diagnosis considered was a gastrointestinal stromal tumor. Intra-operatively, the mass was confined exclusively to the transverse mesocolon. Microscopy revealed a cellular tumor composed of oval to elongate neoplastic cells with hyperchromatic nuclei, inconspicuous nucleoli and were immunoreactive for CD10, progesterone receptor (PR), estrogen receptor (ER), and PAX8; negative for KIT, CD34, SMA, S100, synaptophysin, chromogranin, WT-1, and calretinin. A distinct arborizing network of arterioles along with foci of endometriosis was also seen. We present this case for its extreme rarity and the challenges entailed in its diagnosis.
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Affiliation(s)
- Aishwarya Sharma
- Tata Memorial Hospital, Homi Bhabha National institute, Mumbai 400012, Maharashtra, India
| | - Munita Bal
- Tata Memorial Hospital, Homi Bhabha National institute, Mumbai 400012, Maharashtra, India
| | - Santosh Menon
- Tata Memorial Hospital, Homi Bhabha National institute, Mumbai 400012, Maharashtra, India
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5
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Asokan R, Joseph LD, Mohanendran A, Krishnamoorthy S. Isolated ureteral extrauterine endometrial stromal sarcoma: an unusual presentation. BMJ Case Rep 2021; 14:e245099. [PMID: 34544718 PMCID: PMC8454433 DOI: 10.1136/bcr-2021-245099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 12/31/2022] Open
Abstract
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.
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Affiliation(s)
- Raghavendran Asokan
- Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Leena Dennis Joseph
- Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Arthi Mohanendran
- Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Sriram Krishnamoorthy
- Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
- Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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6
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Wang B, Liu L, Li N, Zhao J, Dai C, Dai X, Li J. High-grade endometrial stromal sarcoma of the endocervix: An extremely rare case report. Int J Gynaecol Obstet 2021; 156:372-374. [PMID: 34418876 DOI: 10.1002/ijgo.13891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/19/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Bei Wang
- Hebei General, Hospital, Shijiazhuang, Hebei, China
| | - Liping Liu
- Hebei General, Hospital, Shijiazhuang, Hebei, China.,North China University of Science and Technology, Tangshan, Hebei, China
| | - Na Li
- Hebei General, Hospital, Shijiazhuang, Hebei, China
| | - Jing Zhao
- Hebei General, Hospital, Shijiazhuang, Hebei, China
| | - Congwei Dai
- Hebei General, Hospital, Shijiazhuang, Hebei, China
| | - Xiaowei Dai
- Beijing Institute of Tuberculosis Control Central Laboratory, Beijing, China
| | - Jianli Li
- Hebei General, Hospital, Shijiazhuang, Hebei, China
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7
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Mercier NB, Roberts LF, Azordegan N, Altman AD. Extra-uterine endometrial stromal sarcoma of the left adnexa and distal ureter: A case report. Gynecol Oncol Rep 2021; 36:100702. [PMID: 33553557 PMCID: PMC7851353 DOI: 10.1016/j.gore.2021.100702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/02/2021] [Accepted: 01/10/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Nora-Beth Mercier
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lesley F Roberts
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nazila Azordegan
- Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alon D Altman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Gorostiaga I, Perez-Rodriguez A, Gómez-Mateo MC, Cuadra-Cestafe M, Sagasta A. Low-grade extrauterine endometrial stromal sarcoma of the peritoneum: A case report and literature review. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2020; 54:201-205. [PMID: 34175034 DOI: 10.1016/j.patol.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/18/2020] [Accepted: 06/24/2020] [Indexed: 10/23/2022]
Abstract
Endometrial stromal sarcoma (ESS) is an uncommon mesenchymal tumor that accounts for less than 1% of all primary uterine malignancies and extrauterine endometrial stromal sarcoma (EESS) is even rarer. We report the case of a 75-year-old woman with an abdominal tumor and multiple peritoneal implants. Histological analysis of the surgical specimens showed bland cellularity resembling normal endometrial stroma. The diagnosis of a low-grade EESS was confirmed by immunophenotypic findings and demonstration of JAZF1 translocation. After extensive sampling, no evidence of endometriosis was found. Our case showed atypical aggressive behavior and we discuss the possible influence of the high mitotic count (8/10 HPFs) in some areas of the tumor, the multifocality of the abdominal implants and the postmenopausal status of the patient. The unusual clinical presentation and extrauterine location of such a rare tumor were challenging implying a wide range of differential diagnosis. The correlation of morphological, immunohistochemical and molecular findings was necessary to arrive at the correct diagnosis.
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Affiliation(s)
- Iñigo Gorostiaga
- Bioaraba Research Health Institute, Vitoria-Gasteiz, Spain; Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, Alava, Vitoria-Gasteiz, Spain.
| | - Alvaro Perez-Rodriguez
- Bioaraba Research Health Institute, Vitoria-Gasteiz, Spain; Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, Alava, Vitoria-Gasteiz, Spain
| | | | - María Cuadra-Cestafe
- Bioaraba Research Health Institute, Vitoria-Gasteiz, Spain; Osakidetza Basque Health Service, Araba University Hospital, Gynecology Department, Vitoria-Gasteiz, Spain
| | - Amaia Sagasta
- Bioaraba Research Health Institute, Vitoria-Gasteiz, Spain; Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, Alava, Vitoria-Gasteiz, Spain
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9
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Alan S, Yilmaz E, Tecellioglu F, Akatli AN, Inci Coskun E, Gokce H. Multifocal low-grade endometrial stromal sarcoma arising from pre-existing endometriosis in a hysterectomised patient: a case report. J OBSTET GYNAECOL 2019; 39:1177-1180. [PMID: 31195864 DOI: 10.1080/01443615.2019.1587599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Saadet Alan
- Department of Pathology, Inonu University School of Medicine, Turgut Ozal Medical Center , Malatya , Turkey
| | - Ercan Yilmaz
- Department of Gynecology and Obstetrics, Inonu University School of Medicine, Turgut Ozal Medical Center , Malatya , Turkey
| | - Fahriye Tecellioglu
- Department of Pathology, Inonu University School of Medicine, Turgut Ozal Medical Center , Malatya , Turkey
| | - Ayse Nur Akatli
- Department of Pathology, Inonu University School of Medicine, Turgut Ozal Medical Center , Malatya , Turkey
| | - Ebru Inci Coskun
- Department of Gynecology and Obstetrics, Inonu University School of Medicine, Turgut Ozal Medical Center , Malatya , Turkey
| | - Hasan Gokce
- Department of Pathology, Inonu University School of Medicine, Turgut Ozal Medical Center , Malatya , Turkey
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Dong Y, Braden B, Klinger C, Ripolles T, Dietrich CF. Ultrasound findings in extragenital endometriosis. J Ultrason 2018; 18:247-254. [PMID: 30427131 PMCID: PMC6442214 DOI: 10.15557/jou.2018.0036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We present a report on ultrasound findings in extragenital endometriosis and a literature review accompanied by illustrations. Intestinal endometriosis should be considered in female patients of reproductive age who present with constipation, gastrointestinal bleeding, nausea, vomiting, cramp-like abdominal pain, diarrhoea and pelvic pain. Although definitive preoperative diagnosis of endometriosis is difficult, clinical suspicion and appropriate imaging might prevent extensive surgical procedures with higher morbidity. Contrast-enhanced ultrasound is an efficient non-invasive imaging method without any radiation exposure that supports the early diagnosis of intestinal endometriosis and may help assess the vascularization of endometriotic lesions within the distinct layers of the intestinal wall.
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Affiliation(s)
- Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, UK
| | | | - Tomás Ripolles
- Department of Radiology, Dr Peset Universitary Hospital, Valencia, Spain
| | - Christoph F Dietrich
- Medizinische Klinik 2, Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany
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