Endometrial stromal sarcomas: immunoprofile with emphasis on HMB45 reactivity.
OBJECTIVE
We describe the morphologic and immunohistochemical features of 17 endometrial stromal neoplasms, 16 sarcomas, and one stromal nodule.


METHODS
We reviewed 35 cases interpreted as endometrial stromal neoplasms, but 17 high-grade endometrial stromal sarcomas (ESS) and one case of mixed endometrial sarcoma and leiomyosarcoma were excluded from the study. Data from the Surveillance Epidemiology and End Results program on low- and high-grade ESS for 1973 through 2003 were obtained.


RESULTS
One uterine primary ESS had collections of clear cells (20%), while a metastatic ESS contained predominantly clear cells (90%). CD10 (88.2%) and smooth muscle actin (70.5%) were the most common positive immunohistochemical markers. The latter marker was located in the cytoplasm in 47% of the ESS and in the nucleus in 23.5%, a previously unreported feature. HMB45 was detected in 23.5% of the ESS, which contrasts with the 2% reported by other authors.


CONCLUSIONS
The presence of clear cells and HMB45 reactivity does not justify the term perivascular epithelioid cell tumors for these neoplasms. Two of 17 patients with ESS died of metastatic disease. However, among 274 cases of ESS (all stages included) collected by the Surveillance Epidemiology and End Results Program of the National Cancer Institute during a 30-year period, the 10-year survival rate was 94%.
From Medica Sur Clinic and Foundation, México City, México; Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán," México City, México; dralboresjorge@gmail.com.
Jorge
J
Albores-Saavedra
From Medica Sur Clinic and Foundation, México City, México; Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán," México City, México;
Rita
R
Dorantes-Heredia
From Medica Sur Clinic and Foundation, México City, México;
Fredy
F
Chablé-Montero
Instituto Nacional de Cancerología de México, México City, México;
José
J
Chanona-Vilchis
Instituto Nacional de Cancerología de México, México City, México;
Delia
D
Pérez-Montiel
From Medica Sur Clinic and Foundation, México City, México;
Leonardo Saúl
LS
Lino-Silva
Hospital de Alta Especialidad "Dr. Juan Graham Casasús," Villahermosa, México; and.
Marco Aurelio
MA
González-Romo
From Medica Sur Clinic and Foundation, México City, México;
José Manuel
JM
Ramírez-Jaramillo
George Washington University Cancer Institute, Washington, DC.
Donald E
DE
Henson
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D004717:Endometrium / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D058950:Melanoma-Specific Antigens / Q000378:metabolism*; D008875:Middle Aged; D018203:Sarcoma, Endometrial Stromal / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000556:secondary; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology; D058951:gp100 Melanoma Antigen
D014408:Biomarkers, Tumor; D058950:Melanoma-Specific Antigens; C548637:PMEL protein, human; D058951:gp100 Melanoma Antigen
Endometrial stromal sarcoma; Immunohistochemistry; PEComa; Stromal nodule