title: The diagnostic problem of endometrial stromal sarcoma: report on six cases.
abstract: OBJECTIVE
  The objective was to look for the incidence and clinicopathologic findings of women in whom the diagnosis of endometrial stromal sarcoma was initially missed.
  
  
  METHODS
  We carried out a retrospective analysis of cases treated at our institution from 1990 to 2002.
  
  
  RESULTS
  In 6/15 (40%) women suffering from endometrial stromal sarcoma, the diagnosis initially was missed. The first diagnosis was uterine leiomyoma (n = 2), myxoid leiomyoma (n = 2), cellular leiomyoma (n = 1), or lymphatic disorder (n = 1). The final diagnosis was only made after consultation of a pathologist with a special interest in gynecological oncology. The mean age of this group was only 34 years (range, 18-53). A mean delay in diagnosis of 143 months (range, 24-408) resulted in stage 4 disease in 5/6 women. After a mean follow-up of 16 years (range, 5-43), 4/6 are without macroscopic evidence of disease, 1/6 with evidence of disease, and 1/6 died of disease.
  
  
  CONCLUSIONS
  Especially in younger women, the diagnosis of endometrial stromal sarcoma can be problematic.
authors.affiliation: Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven 3000, Belgium. Frederic.Amant@uz.kuleuven.ac.be
authors.forename: Frédéric
authors.initials: F
authors.lastname: Amant
authors.forename: Philippe
authors.initials: P
authors.lastname: Moerman
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cadron
authors.forename: Patrick
authors.initials: P
authors.lastname: Neven
authors.forename: Patrick
authors.initials: P
authors.lastname: Berteloot
authors.forename: Ignace
authors.initials: I
authors.lastname: Vergote
mesh_terms: D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D018203:Sarcoma, Endometrial Stromal / Q000175:diagnosis* / Q000473:pathology; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology