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KMID : 0390320120220010067
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Chungbuk Medical Journal
2012 Volume.22 No. 1 p.67 ~ p.74
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A Case of Endometrial Stromal Sarcoma
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Kim Hak-Soon
Hong Seung-Hwa
Park Yeon-Jin
Ji Il-Woon
Jeong Eun-Hwan
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Abstract
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Uterine sarcomas are relatively rare tumors of mesodermal origin comprising 2 to 6 percent of uterine malignancies. Uterine sarcomas are one of the most malignant groups of uterine tumors. Endometrial stromal sarcoma (ESS) makes up about 27% of uterine sarcomas according to four domestic reports. It is possible to diagnosis ESS by endometrial biopsy with curettage or hysteroscopy, but usually definitive diagnosis is confirmed incidentally after surgical pathologic examination. ESS shows indolent behavior with late recurrence and distant metastasis. Either prolonged survival or cure is not uncommon following surgical removal of recurrent or metastatic disease. This 39 years-old woman complains abnormal uterine bleeding. The vaginal USG finding looks like submucosal myoma, while endometrial curettage biopsy
directs low-grade ESS. Radical hysterectomy including both adnexectomy and pelvic lymph node dissection reveals only myometrial invasion without extra-uterine extension. Postoperative whole pelvic radiation was included and both lung metastases were found 3 years later. We gave progesterone therapy for 6 months which ended up with no improvement, and tried combination chemotherapy for more than 6 cycles. However, the patient died from respiratory failure 5 years and 5 months after the surgery.
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KEYWORD
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Uterine sarcoma, Low-grade, Endometrial stromal sarcoma
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