Histopathological study of endometrial stromal sarcomas

Authors

  • Salma Bhat Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
  • Ambreen Beigh Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
  • Summyia Farooq Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20184935

Keywords:

Endometrial, Histology, Sarcoma, Stromal

Abstract

Background: Endometrial stromal sarcomas (ESSs) are rare malignant uterine tumours comparatively affecting younger women and the mean age is 42 to 58 years. The World Health Organization (WHO) classification categorises endometrial stromal neoplasms and related tumors as: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS).

Methods: Present study is a retrospective one and includes 6 patients with histologically proven endometrial stromal sarcoma for a period of 3 years. Authors examined every slide available from each case and new HE-stained slides generated from formaline-fixed, paraffin-embedded tissue were reviewed to confirm the diagnoses. Demographic information, pathologic, and treatment information were collected from the clinic and hospital charts. All had primary surgical management in the form of total abdominal hysterectomy and salpingo-oophorectomy.

Results: The mean patient age was 41 years. All of the patients had presented with abnormal uterine bleeding. Diffuse growth of small cells closely resembling those of the normal proliferative endometrial stroma was the characteristic feature of these tumors. All of these patients had a low grade ESS on histopathology. They had regular follow-up visits until the end of study.

Conclusions: Endometrial stromal sarcomas are rare malignant tumors of the uterus and a proper preoperative diagnosis is difficult. Their differential diagnosis from typical submucosal uterine myomas or benign endometrial polyps can be difficult. The histological examination of the specimen is necessary to exclude malignancy and establish the final diagnosis.

References

Ashraf-Ganjoei T, Behtash N, Shariat M, Mosavi A. Low grade endometrial stromal sarcoma of uterine corpus, a clinico-pathological and survey study in 14 cases. World J Surg Oncol. 2006;4:50.

Tavassoli FA, Devilee P. WHO Classification of Pathology and genetics of tumours of the breast and female genital organs. In: Tavassoli FA, Devilee P, eds. Lyon, France: IARC Press; 2003:233-236.

Conklin CM, Longacre TA. Endometrial stromal tumors: the new WHO classification. Adv Anat Pathol. 2014;21:383.

Puliyath G, Nair MK. Endometrial stromal sarcoma: A review of the literature. Indian J Med Paediatr Oncol: Official J Indian Soc Med Paediatr Oncol. 2012;33(1):1-6.

Nucci MR, O’Connell JT, Huettner PC, Cviko A, Quade BJ. H- Caldesmon expression effectively distinguishes endometrial stromal tumors from uterine smooth muscle tumors. Am J Surg Pathol. 2001;25(4):455-63.

Diagoni A, Oliva, Clement PB, Young RH. Endometrial stromal nodules and endometrial stromal tumors with limited infiltration. Am J Surg Pathol. 2002;26(5):567-81.

Blythe JG, Bari WA. Uterine sarcoma: Histology, classification and prognosis. Global Lib Women's Med. 2008.

Ashraf-Ganjoei T, Behtash N, Shariat M, Mosavi A. Low grade Endometrial Stromal Sarcoma of uterine corpus, a clinico-pathological and survey study in 14 cases. World J Surg Oncol. 2006;4:50.

Ali RH, Al-Safi R, Al-Waheeb S, John B, Al-Ali W, Al-Jassar W, et al. Molecular characterization of a population-based series of endometrial stromal sarcomas in Kuwait. Hum Pathol. 2014;45:2453-62.

Ansari M, Parulekar SV. Low grade endometrial stromal sarcoma: unusual gross appearance. JPGO 2015;2(4).

Pekindil G, Tuncyurek O, Orguc S, Inceboz U, Kandiloglu AR, Caglar H. A case of endometrial stromal sarcoma with curvilinear calcification. Gynecol Oncol. 2005;98:318-21.

Haberal A, Kayikcioglu F, Boran N, Caliskan E, Ozgul N, Kose MF. Endometrial stromal sarcoma of the uterus: analysis of 25 patients. Eur J Obstet Gynecol Reprod Biol. 2003;109:209-13.

Leath III CA, Huh WK, Hyde Jr J, Cohn DE, Resnick KE, Taylor NP, et al. A multi institutional review of outcomes of endometrial stromal sarcoma. Gynecol Oncol. 2007;105:630-4.

Chan JK, Kawar NM, Shin JY, Osann K, Chen LM, Powell CB, et al. Endometrial stromal sarcoma: a population-based analysis. Brit J Cancer. 2008;99(8):1210-5.

Downloads

Published

2018-11-26

Issue

Section

Original Research Articles