Obstet Gynecol Sci.  2016 Jul;59(4):323-327. 10.5468/ogs.2016.59.4.323.

A case of advanced-stage endometrial stromal sarcoma of the ovary arising from endometriosis

• Back JA
• Choi MG
• Ju UC
• Kang WD
• Kim SM

• KMID: 2329056
• DOI: http://doi.org/10.5468/ogs.2016.59.4.323

Abstract

Endometrial stromal sarcoma (ESS) is a rare malignancy. Development of extrauterine ESS form endometriosis is particularly rare. The majority of extrauterine ESS occurs in areas with preexisting endometriosis. The most common site is the ovary. We experienced a case of ESS of the ovary that arose from endometriosis with multiple disseminated lesions. This disease was managed by total abdominal hysterectomy, bilateral salpingo-oophorectomy, both pelvic lymph nodes dissection, omentectomy, and appendectomy followed by postoperative high-dose progesterone therapy. Here, we report this case with literature review.

Keyword

Endometrial stromal sarcoma; Endometriosis; Ovary

MeSH Terms

Appendectomy
Endometriosis*
Female
Hysterectomy
Lymph Nodes
Ovary*
Progesterone
Sarcoma, Endometrial Stromal*
Progesterone

Figure

• 

  Fig. 1 Pelvic magnetic resonance imaging finding. (A) A 6.0×4.8×5.3-cm3 ill-defined, heterogeneous signal intensity mass, including mixed cystic and solid portions in the right ovary. This mass was considered as a malignancy (i.e., clear cell carcinoma). Between the posterior portion of the right ovarian tumor and the cul-de-sac, there was a 5.5×5.0-cm2 enhanced solid mass with an irregular margin invading into the rectal serosa. (B) A 7.2×5.9×6.1-cm3 multi-septated cystic mass in the left ovary that was considered as a benign mucinous cystadenoma.

• 

  Fig. 2 Microscopic, immunohistochemical, and macroscopic finding. (A) Stromal tissue had the characteristic tongue-like growth pattern (H&E, ×40). (B) Positive for Ki 67 (Ki index 3% to 5%, ×400). (C) Positive for cluster of differentiation 10 (×200). (D) Positive for progesterone receptor (×400). (E) The right ovary, which was measured roughly 5 cm, contained a 3 cm solid mass and chocolate-colored fluid. There was no intrauterine tumor.

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