scholarly journals Recurrent Endometrial Stromal Sarcoma: Treatment with a Progestin and Gonadotropin Releasing Hormone Agonist

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Nefertiti Chianti duPont ◽  
Philip John DiSaia
Keyword(s):  
Combined Therapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Good Prognosis ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
Sarcoma Treatment

Endometrial stromal sarcoma (ESS) formerly classified as low-grade endometrial stromal sarcoma is a rare uterine malignancy with a good prognosis despite a tendency to recur. Primary surgical management for ESS includes total abdominal hysterectomy and bilateral salpingo-oophorectomy. Patients with ESS have long disease-free survival rates when treated with primary surgical therapy, but nearly fifty percent of these patients will recur. We present the case of a patient with recurrent ESS who had an excellent response to combined therapy with megestrol and leuprolide.

scholarly journals Article Evaluation of treatment strategies and prognostic factors of 135 patients with low-grade endometrial stromal sarcoma

2019 ◽  
Author(s):  
Huaying Wang ◽  
Shanhui Liang ◽  
Zheng Feng ◽  
Liangfang Xia ◽  
Jun Zhu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymphovascular Invasion ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
Free Survival ◽  
Stromal Sarcoma ◽  
Disease Free

Abstract Background: To evaluate the influence of treatment modalities and prognostic factors on the survival of patients with low-grade endometrial stromal sarcoma (LGESS). Methods: One hundred and thirty-five LGESS patients in Fudan University Shanghai Cancer Center from January 2006 to December 2018 were retrospectively reviewed. Results: Two patients received fertility-sparing surgery while 133 patients received hysterectomy. The median follow-up duration was 52 months (3–342 months). One hundred and nine (80.7%) patients received ovariectomy, 73 (54.1%) patients had lymphadenectomy, 83 (61.5%) patients received adjuvant therapy. The 5-year and 10-year disease free survival rates were 72.0% and 61.0%, respectively. The 5-year and 10-year overall survival rates were 88.0% and 79.8%, respectively. Surgery for recurrence was associated with improved overall survival although the complication rate was about 27.6%. Multivariate analysis showed that lymphovascular invasion was associated with disease free survival (hazard ratio, 0.473; 95 % confidence interval, 0.235–0.952; p=0.036) and menopausal status was related to overall survival (hazard ratio, 5.561; 95 % confidence interval, 1.400–22.084; p=0.015). Conclusions: There was no effect of lymphadenectomy, ovariectomy, or adjuvant therapy on patients’ recurrence and survival. Hysterectomy may be proposed as the standard treatment for LGESS. Surgery for replase was an acceptable method to improve overall survival. Lymphovascular invasion was a significant independent factor for disease free survival. Postmenopause was the poor prognostic factor for overall survival.

scholarly journals Endometrial Stromal Sarcoma Recurrence in the Caecum

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Nisar A. Chowdri ◽  
Asif Mehraj ◽  
Fazl Q. Parray ◽  
Mudassir A. Khan ◽  
Masood A. Laharwal ◽  
...  
Keyword(s):  
Rare Case ◽  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Low Grade ◽  
Lower Abdomen ◽  
Polypoidal Lesion ◽  
Stromal Sarcoma ◽  
The Right

Endometrial stromal sarcomas of uterus are quite rare. Most of the recurrences in these tumors are seen in the pelvis. However, extrapelvic recurrences and metastases to other parts are quite unusual. Here, we are reporting a rare case of caecal recurrence of endometrial stromal sarcoma. Case Report. A 52-year-old female presented to us with pain and lump in the right lower abdomen. The patient was earlier subjected to total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAHBSO) for low-grade endometrial stromal sarcoma. Postoperatively patient received radiotherapy but no hormone therapy. After 10 years of follow up patient presented with a polypoidal lesion in the caecum. Patient was evaluated fully and subjected to resection of this polypoidal lesion, which proved out to be high-grade endometrial stromal sarcoma. Conclusion. Recurrence of endometrial stromal sarcoma in the caecum is very rare. However, this entity needs to be kept in mind for differential diagnosis of a caecal mass. Recurrence in such cases may present quite late.

Extrauterine endometrial stromal sarcoma arising in a background of endometriosis following prior total abdominal hysterectomy

2018 ◽  
Vol 10 (3) ◽  
pp. 133-135
Author(s):  
Jonathan Chapman ◽  
Blake Bartholomew ◽  
Sayf Al-Katib
Keyword(s):  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Imaging Findings ◽  
Stromal Sarcoma

This article describes a case of endometrial stromal sarcoma arising in a background of endometriosis presenting several years after total abdominal hysterectomy. Discussion of endometrial stromal sarcoma ensues as well as review of pertinent imaging findings.

Low-grade endometrial stromal sarcoma: a single center's experience with 22 cases

2008 ◽  
Vol 18 (5) ◽  
pp. 1084-1089 ◽  
Author(s):  
W. Y. Kim ◽  
J.-W. Lee ◽  
C. H. Choi ◽  
H. Kang ◽  
T.-J. Kim ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Disease Recurrence ◽  
Primary Treatment ◽  
Stage I ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
Case Surgery ◽  
Abnormal Vaginal Bleeding ◽  
Disease Free

The aim of this retrospective study was to evaluate the clinical behavior and management outcome of low-grade endometrial stromal sarcoma (LGESS). From September 1994, to March 2007, 22 patients with histologically proven stage I LGESS were included in this study. Clinicopathologic variables, recurrence, and management outcomes were reviewed retrospectively. The median age of the 22 patients was 43 years. The most common presenting symptom was abnormal vaginal bleeding. All patients underwent a hysterectomy and had stage I disease. Six patients had adjuvant therapy after the hysterectomy. The median follow-up period was 77 months (range 12–202 months). Ten patients had disease recurrence. The median disease-free survival period was 111 months (range 6–182 months). The pelvis (eight cases) was the most common site of recurrence followed by the lung (four cases) and the liver (one case). Recurrent disease was treated with surgery (one case), surgery plus chemotherapy (five cases), chemotherapy (two cases), and surgery plus radiotherapy (two cases). Two patients died after 25 and 54 months after disease recurrence. Treatment with a bilateral salpingo-oophorectomy or adjuvant chemoradiation did not affect the disease-free interval. LGESS is usually a slow-growing neoplasm with an indolent clinical course. Surgery is the primary treatment for recurrent endometrial stromal sarcoma when feasible. Adjuvant treatment (radiotherapy, chemotherapy, or both) had no effect on the prognosis of patients with stage I disease

Retrospective analysis of 105 cases of uterine sarcoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16079-16079
Author(s):  
A. Yoney ◽  
S. Eskici ◽  
B. Eren ◽  
A. Salman ◽  
M. Unsal
Keyword(s):  
Therapeutic Option ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Sarcoma ◽  
Therapeutic Modality ◽  
Uterine Sarcomas ◽  
Pathologic Classification

16079 Background: Currently there is no randomized study based or widely accepted therapeutic modality in uterine sarcomas which are rare tumors forming a heterogeneous group in respect to their pathologic classification. Methods: In our trial, 105 pts. with uterine sarcoma who were referred to our clinic between years 1995–2003 have been retrospectively researched to evaluate the results in this tumor group. 43.8% had Leiomyosarcoma (LMS), 28.6% had Endometrial Stromal Sarcoma (ESS) and 27.6% had a Malign Mullarian Mixed Tumor (MMMT) while the distribution according to the histological subgroups were found to be 58.8% and 41.2% in low + middle grade tumors combined and in high grade tumors respectively. 76.2% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy (TAH+BSO), 18.1% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy + Lymphadenectomy (TAH+BSO+LND) and 5.7% had a suboptimal surgery as a surgical procedure. 38.1% of the pts. had Radiotherapy (RT), 18.1% had Chemotherapy (CT) and 12.4% had Chemo-radiotherapy (CT+RT) in addition to surgery. Results: The median age of the whole group is 51 (24–87). 55% of our pts. are under 50 years old and 68.5% had an “organ limited disease” ( stages I-II combined). The distant metastases rate is 30% and the local recurrence is 16.2%. All the local recurrences and 90% of the distant metastases have occurred within the first two years. The disease free survival rates at 3 and 5 years are 54.46% and 49.88% ; while the overall survival rates at 3 and 5 years are 54.63% and 51.09% all respectively. The stage is the most important factor effecting on the O.S and 5- year O.S rate is 68.43% in Stage I disease. Conclusions: The aggressive tumor progression pattern and the poor prognosis of uterine sarcomas require adjuvant therapies. The merit of current therapeutic options are still on debate since none of them has proved any specific effects. Planning further multi-center retrospective studies with high number of pts., a more clear description of the prognostic factors and thus the determination of the most appropriate therapeutic option is definitely needed. No significant financial relationships to disclose.

Isolated ureteral extrauterine endometrial stromal sarcoma: an unusual presentation

2021 ◽  
Vol 14 (9) ◽  
pp. e245099
Author(s):  
Raghavendran Asokan ◽  
Leena Dennis Joseph ◽  
Arthi Mohanendran ◽  
Sriram Krishnamoorthy
Keyword(s):  
De Novo ◽  
Radical Mastectomy ◽  
Hormonal Treatment ◽  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Definitive Treatment ◽  
Stromal Sarcoma ◽  
First Case ◽  
Rare Tumours

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.

scholarly journals Retrospective analysis of clinical, pathological characteristics and prognosis of the patients with endometrial stromal sarcomas

2020 ◽  
Vol 7 (1) ◽  
pp. 360-363
Author(s):  
Hacı Öztürk Şahin ◽  
Mehmet Bayrak
Keyword(s):  
Clinical Characteristics ◽  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Lymph Node Involvement ◽  
Endometrial Biopsy ◽  
Low Grade ◽  
High Grade ◽  
Gynecology And Obstetrics ◽  
Paraaortic Lymph Nodes

Objective: Endometrial stromal sarcoma (ESS) is a rare mesenchymal tumor of the uterus.Literature has limited data about the ESS. The aim of the present study was to contribute to literature by reporting the histo-pathological findings, clinical characteristics of ESS patients and the data about the accuracy of preoperative diagnosis and prognosis. Material and Methods: A total of 33 patients who were diagnosed and followed up with ESS at Department of Gynecology and Obstetrics of Bursa Uludağ University between 2007 and 2017 were retrospectively analyzed with regard to clinical and pathologic characteristics, surgical procedures they underwent and survival. Results: Mean age of the patients was 49.5 years and 60.2 years for low grade ESS (LG-ESS) and high grade ESS (HG-ESS) (p=0,01). Post-menopausal hemorrhage was the most common complaint on admission.  Correct histological diagnosis was made in only 72.7% of the patients from whom pre-operative endometrial biopsy was obtained. Twelve out of 16 cases (75%) were in Stage 1. While all patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO), 14 underwent pelvic and para-aortic lymphadenectomy for surgical staging. Lymph node involvement was detected in no patients who underwent lymphadenectomy. The patients with LG-ESS were found to have a good prognosis however the ones with HG-ESS had a high mortality rate even in the early stages (mean survival of 10 months). Conclusion: High grade ESS cases show different clinical characteristics and prognosis than LG-HSS. Diagnostic accuracy of endometrial sampling is much lower when compared to epithelial uterine malignancies. Metastasis of pelvic-paraaortic lymph nodes of which removal is reported which not to contribute to survival is rare.

Epithelial ovarian tumors of borderline malignancy: a study of 50 cases

1992 ◽  
Vol 2 (4) ◽  
pp. 189-197 ◽  
Author(s):  
B. Piura ◽  
R. Dgani ◽  
I. Blickstein ◽  
I. Yanai-Inbar ◽  
B. Czernobilsky ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumors ◽  
Adequate Treatment ◽  
Initial Surgery ◽  
Stage Ia ◽  
Borderline Malignancy

Of 50 patients with borderline epithelial ovarian tumors, 32 (64%) had serous, 17 (34%) had mucinous and one (2%) had endometrioid tumor. All patients with mucinous tumor had stage I disease, whereas 4 patients with serous tumor had stage II–III disease. Five patients (10%) were pregnant at the time of diagnosis. Seventeen patients (34%) had initial surgery with ovarian conservation and 7 of them were not subjected to further surgery. Five patients (10%) received adjuvant chemotherapy. Five-year survival and 5-year disease-free survival rates were 100% and 96.4%, respectively. It is concluded that for patients with stage IA disease unilateral salpingo-oophorectomy seems to be adequate treatment and for those with more than stage IA disease, surgery should include total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although the effectiveness of chemotherapy in these tumors is uncertain, adjuvant chemotherapy is advocated for patients in whom spread of the tumor beyond the ovaries has occurred.

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