title: Transition from low-grade endometrial stromal sarcoma to high-grade endometrial stromal sarcoma.
abstract: We report on a case of a primary low-grade endometrial stromal sarcoma (ESS) that progressed to a secondary high-grade ESS. In the secondary tumor, the immunohistochemical profile and focal tumor cell proliferation pattern suggested that this tumor was not truly undifferentiated, but possessed features of endometrial stroma. Low-grade ESS of our patient's primary tumor showed p53 protein overexpression, which is unusual in low-grade ESS, and her secondary high-grade ESS showed more prominent p53 immunoreactivity. This indicates that low-grade ESS that shows p53 immunoreactivity might progress to high-grade ESS, and it is considered that such cases of low-grade ESS should pay attention to the prognosis. Immunoreactivity for epidermal growth factor receptor was observed in both tumors, suggesting a relationship between the primary and secondary tumors in our case. Further study requires more immunohistochemical data for cases in which low-grade ESS transitions to high-grade ESS; in particular, data on epidermal growth factor receptor expression are necessary to define new therapeutic strategies for ESS.
authors.affiliation: Department of Pathology, Showa University, Northern Yokohama Hospital, Yokohama, Kanagawa, Japan. yomareko@cmed.showa-u.ac.jp
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Ohta
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Omatsu
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Hamatani
authors.forename: Akira
authors.initials: A
authors.lastname: Shiokawa
authors.forename: Miki
authors.initials: M
authors.lastname: Kushima
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Ota
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D066246:ErbB Receptors / Q000378:metabolism*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018203:Sarcoma, Endometrial Stromal / Q000378:metabolism / Q000473:pathology*; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D016159:Tumor Suppressor Protein p53; D066246:ErbB Receptors