Endometrial stromal sarcoma(ESS) is a rare uterine malignancy, especially in a young woman and it is variable in morphologic characteristics and clinical progresses.
Endometrial stromal sarcomas are divided into three groups, based on mitotic activity and vascular invasion(Endometrial stromal nodule, low-grade ESS, high grade ESS). And these distiction are important for the prognosis of the patient.
We now describe a case of low-grade malignant ESS, which was diagnosed in a 20 yearold, unmarried woman with an enlarged uterus. She had received four courses of GnRH agonist (GnRH-a) treatment before the exploration. Exploration was planned
spite
of
that the uterine size was not reduced at all. Total abdominal hysterectomy and bilateral salpingoophorectomy were performed because the frozen biopsy resulted in a low-grade ESS. The final pathologic examination also revealed a low-grade ESS. She
was
started on an adjuvant hormonal therapy with megeterol acetate, 80mg per day, and will be followed closely with serial clinical exams and computerized tomography scan. The possibility of a delayed diagnosis of unsuspected sarcoma when using
GnRH-a
is
thought as an inherent and apparently unavoidable complication in some cases like this.
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