Surgical cytoreduction and hormone therapy of an advanced endometrial stromal sarcoma of the ovary.
BACKGROUND
Primary endometrial stromal sarcomas of the ovary are rare gynecologic malignancies. We report a disseminated case of this tumor arising from ovarian endometriosis.


METHODS
A 45-year-old woman presented with an abdominal pelvic mass and an elevated CA 125. Exploration showed extensive tumor spread from the ovaries to the upper abdomen. Surgery included a total hysterectomy, bilateral salpingo-oophorectomy, splenectomy, partial gastrectomy, partial pancreatectomy, transverse colectomy, appendectomy, and omentectomy. Final pathology showed a low-grade endometrial stromal sarcoma of the ovary arising from foci of endometriosis. Megestrol acetate was initiated, and she is currently without evidence of disease.


CONCLUSIONS
This is an advanced case of a primary low-grade endometrial stromal sarcoma of the ovary arising from endometriosis managed by total resection and progestational therapy.
Geas
Felicia L
FL
Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, California 92668, USA.
Tewari
Devansu S
DS
Rutgers
Joanne K L
JK
Tewari
Krishnansu S
KS
Berman
Michael L
ML
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004715:Endometriosis / Q000473:pathology; D005260:Female; D006801:Humans; D019290:Megestrol Acetate / Q000627:therapeutic use*; D008875:Middle Aged; D010049:Ovarian Diseases / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D010053:Ovary / Q000473:pathology; D018203:Sarcoma, Endometrial Stromal / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*
D018931:Antineoplastic Agents, Hormonal; D019290:Megestrol Acetate