Low-grade endometrial stromal sarcoma with retroperitoneal metastases: an unusual case report.
BACKGROUND
Endometrial stromal sarcoma (ESS) is an uncommon malign neoplasm, and its occurrence outside the uterus is extremely rare in the absence of metastasis or extension of a primary uterine neoplasm. When arising in the pelvis or abdominal cavity, ESS is associated with uterine adnexa or serosal surface of various organs.


METHODS
We present the case of a 46-year-old woman with lower abdominal pain and regular menstruation who underwent laparotomy after a diagnosis of pelvic mass mimicking a right adnexial tumor. Exploration of the pelvis revealed a retroperitoneal mass of 15 cm in diameter in the right illiac fossa without accompanying pelvic or paraaortic lymphadenopathy. Uterus and ovaries were bilaterally normal in size. The pathology showed low-grade ESS of the uterus with direct spread to retroperitoneum without serosal metastases.


CONCLUSIONS
This case shows that despite its well-known good prognostic nature, low-grade ESS may behave as an aggressive malignancy.
Guzelmeric
Kadir
K
Department of Obstetrics and Gynecology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. kguzelmeric@yahoo.com
Ergen
Bahar
B
Pirimoglu
Zehra Meltem
ZM
Gecer
Melin Ozgun
MO
Unal
Orhan
O
Turan
Cem
C
D016889:Endometrial Neoplasms / Q000473:pathology*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D010052:Ovariectomy; D012186:Retroperitoneal Neoplasms / Q000556:secondary*; D018203:Sarcoma, Endometrial Stromal / Q000473:pathology* / Q000556:secondary*