title: Metastatic low-grade endometrial stromal sarcoma of clitoris: report of a case.
abstract: Low-grade endometrial stromal sarcoma (ESS) is an uncommon neoplasm, which has a highly recurrent nature. A review of the literature revealed that only one case of low-grade ESS, arising within the vulva from a focus of endometriosis, has been previously published. We describe an additional case of low-grade ESS arising within the vulva and to the best of our knowledge the first report of low-grade ESS metastasized to clitoris. A 46-year-old woman was admitted to our hospital due to a heavy uterine bleeding. A physical examination revealed a lesion in clitoris, which exhibited a densely cellular mesenchymal neoplasm on microscopy. On the basis of the pathologic features alone, a differential diagnosis of a low-grade ESS and cellular leiomyoma was considered. Seven months later, the patient presented again with excessive uterine bleeding and a total hysterectomy was performed. A tumor of white-tan, whorled appearance was found. Its features were suggestive of low-grade ESS. Taking into account the possible extrauterine location of an ESS and reviewing the first case, a diagnosis of rare low-grade ESS metastasized to clitoris was made.
authors.affiliation: Department of Pathology, Laiko General Hospital of Athens, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Androulaki
authors.forename: T G
authors.initials: TG
authors.lastname: Papathomas
authors.forename: P
authors.initials: P
authors.lastname: Alexandrou
authors.forename: A C
authors.initials: AC
authors.lastname: Lazaris
mesh_terms: D002987:Clitoris / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018203:Sarcoma, Endometrial Stromal / Q000473:pathology / Q000556:secondary*; D014846:Vulvar Neoplasms / Q000556:secondary*