title: Prolonged stabilization of progressive endometrial stromal sarcoma with prolonged oral etoposide therapy.
abstract: We report the case of a patient who has a 23-year history of endometrial stromal sarcoma (ESS). She initially underwent tumor-reductive surgery followed by adjuvant radiotherapy. The pelvic tumor recurred nearly 8 years later, obstructing the ureter and directly invading the bladder. It propagated into the vena cava as a thrombus and finally spread into the right heart chambers, leading to cardiac failure 13 years after the recurrence. The patient was treated with hormonal therapy, multiple resections of the pelvic tumor, chemoembolization, and systemic chemotherapy with doxorubicin and cyclophosphamide. She developed recurrent intractable symptoms and was started on prolonged oral etoposide therapy, which stabilized the size of the pelvic tumor and relieved her symptoms for 3 years. Her quality of life has markedly improved without significant morbidity. We review the options for treating recurrent ESS and suggest that use of prolonged oral etoposide therapy warrants further study in this setting.
authors.affiliation: University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: Y C
authors.initials: YC
authors.lastname: Lin
authors.forename: A P
authors.initials: AP
authors.lastname: Kudelka
authors.forename: D
authors.initials: D
authors.lastname: Tresukosol
authors.forename: A
authors.initials: A
authors.lastname: Malpica
authors.forename: C H
authors.initials: CH
authors.lastname: Carrasco
authors.forename: D D
authors.initials: DD
authors.lastname: Lawrence
authors.forename: R E
authors.initials: RE
authors.lastname: Collier
authors.forename: A
authors.initials: A
authors.lastname: Munoz
authors.forename: L
authors.initials: L
authors.lastname: Delclos
authors.forename: J J
authors.initials: JJ
authors.lastname: Kavanagh
mesh_terms: D000284:Administration, Oral; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005047:Etoposide / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016879:Salvage Therapy; D018203:Sarcoma, Endometrial Stromal / Q000188:drug therapy* / Q000601:surgery
chemical_list: D005047:Etoposide