title: Clinical experience of uterine tumors resembling ovarian sex cord tumors: a clinicopathological analysis of 6 cases.
abstract: OBJECTIVE
  To compare the clinicopathological features, diagnosis, treatment, and prognosis of two types of uterine sex cord-like tumors.
  
  
  METHODS
  The clinicopathological features of four uterine tumors resembling ovarian sex cord tumors (UTROSCTs) and two endometrial stromal tumors with sex cord-like elements (ESTSCLEs) were analyzed retrospectively.
  
  
  RESULTS
  All patients were premenopausal women. The most common clinical presentation was vaginal bleeding (four cases). Total hysterectomy with or without bilateral adnexectomy was the most common treatment pattern (five cases). A patient with UTROSCTs, presenting with recurrence 10 months after transvaginal submucous myomectomy, underwent a total hysterectomy (case 2). All tumors were polypoid or intramural masses, usually located in the uterine fundus or submucosa. The majority of UTROSCTs were positive for cytokeratin (4/4 cases), one was positive for Wilms tumor protein, and of two cases with smooth muscle actin immunoreactivity, two were positive for desmin. UTROSCTs were positive for two or more sex cord markers, whereas sex cord markers were less frequently detected in ESTSCLEs. CD10 was variably positive in two UTROSCT patients and strongly positive in all ESTSCLE patients. Three UTROSCTs and one ESTSCLE were positive for both estrogen and progesterone receptors. All patients with UTROSCTs were alive without evidence of recurrence. One patient with ESTSCLEs underwent postoperative chemotherapy after total vaginal hysterectomy but developed recurrence at the vaginal stump (case 5). The other patient with ESTSCLEs was lost to follow-up.
  
  
  CONCLUSIONS
  These UTROSCTs are polymorphic neoplasms with true sex cord differentiation and uncertain malignant potential, which possess a distinct biology from ESTSCLEs.
authors.affiliation: Clinical College of Central Gynecology and Obstetrics, Tianjin Medical University Tianjin 300070, China ; Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin 300100, China.
authors.forename: Cai-Yan
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Department of Pathology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin 300100, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin 300100, China.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Zhao
authors.affiliation: Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin 300100, China.
authors.forename: Peng-Peng
authors.initials: PP
authors.lastname: Qu
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D036821:Endometrial Stromal Tumors / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D017697:Premenopause; D012086:Reoperation; D018312:Sex Cord-Gonadal Stromal Tumors / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Uterine tumors resembling ovarian sex cord tumors; clinical; diagnosis; endometrial stromal tumors with sex cord-like elements; pathology; treatment outcome