Abstract
Endometrial stromal sarkom (ESS), genellikle perimenopozal kadınlarda görülen uterusun nadir bir malign tümörüdür. Bu olguda akut ağır vajinal kanama ve şiddetli anemi ile başvuran 42 yaşında jinekolojik muayeneyi ve endometriyal örneklemeyi reddeden bir kadın hastayı ele aldık. Transabdominal ultrasonografik değerlendirmede uterusun fundal bölgesinde 9x6 cm boyutlarında intramural submuköz kitle tespit edildi. ESS tanısı, ameliyat öncesi leiomyom olduğu düşünülen tümörün frozen kesiti ile tesadüfen konuldu. Jinekolojik Onkoloji Bölümü ile intraoperatif konsültasyon sonrası total histerektomi ve bilateral salpenjektomi yapıldı. Nihai patolojik raporun ardından hastaya tedavinin sonlandırılması için bilateral ooferektomi önerildi.
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References
- Tropé CG, Abeler VM, and Kristensen GB. Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 2012 ;51(6):694-705.
- Female Genital Tumours: WHO Classification of Tumours, 5th ed.; IARC Publications: Lyon, France, 2020. Akaev, I., Chit Cheng Y., and Siavash Rahimi. Update on Endometrial Stromal Tumours of the Uterus. Diagnostics 11.3 (2021): 429.
- Li A J, Giuntoli RL, Drake R. et al. Ovarian preservation in stage I low-grade endometrial stromal sarcomas. Obstet Gynecol 2005 Dec;106(6):1304-1308.
- Jain R, Batra S, Ahmad A , et al. Low grade endometrial stromal sarcoma: a case report. Iran J Med Sci. 2015 Jan; 40(1): 81–84.
- Horng H C, Wen KC, Wang PH., et al. Uterine sarcoma Part II—Uterine endometrial stromal sarcoma: The TAG systematic review. Taiwan J Obstet Gynecol 2016 Aug;55(4):472-9.
- Wang PH, Horng HC, Chen CP. Is it safe to use minimally invasive surgery in the management of endometrial cancer? Taiwan J Obstet Gynecol. 2016 Apr;55(2):155-6.
- Amant F, Floquet A, Friedlander M et al. Gynecologic Cancer InterGroup (GCIG) consensus review for endometrial stromal sarcoma. Int J Gynecol Cancer 2014 Nov; 24(9 Suppl 3):S67-72.
- ESMO/European Sarcoma Network Working Group. Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25 2014: iii102-iii112.
- Ayhan A, Toptaş T, Oz M et al. Low-grade endometrial stromal sarcoma: A Turkish uterine sarcoma group study analyzing prognostic factors and disease outcomes. Gynecol Oncol 160.3 2021: 674-680.
Abstract
Endometrial stromal sarcoma (ESS) is a rare malignant tumour of the uterus that usually occurs in perimenopausal women. Such a case was a hospitalized 42-year-old woman with acute heavy vaginal bleeding and severe anaemia. The patient refused to have a gynaecological examination and endometrial sampling. However, during the transabdominal ultrasonographic evaluation, an intramural submucous mass of 9 cm × 6 cm was detected in the fundal area of the uterus. The diagnosis of ESS was discovered unexpectedly by examining a frozen section of the tumour that was thought to be leiomyoma preoperatively. After intraoperative consultation with the Gynaecologic Oncology Department, total hysterectomy and bilateral salpingectomy were performed. Once the final pathological report was presented, the patient was recommended to have bilateral oophorectomy in order to proceed with the treatment.
References
- Tropé CG, Abeler VM, and Kristensen GB. Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 2012 ;51(6):694-705.
- Female Genital Tumours: WHO Classification of Tumours, 5th ed.; IARC Publications: Lyon, France, 2020. Akaev, I., Chit Cheng Y., and Siavash Rahimi. Update on Endometrial Stromal Tumours of the Uterus. Diagnostics 11.3 (2021): 429.
- Li A J, Giuntoli RL, Drake R. et al. Ovarian preservation in stage I low-grade endometrial stromal sarcomas. Obstet Gynecol 2005 Dec;106(6):1304-1308.
- Jain R, Batra S, Ahmad A , et al. Low grade endometrial stromal sarcoma: a case report. Iran J Med Sci. 2015 Jan; 40(1): 81–84.
- Horng H C, Wen KC, Wang PH., et al. Uterine sarcoma Part II—Uterine endometrial stromal sarcoma: The TAG systematic review. Taiwan J Obstet Gynecol 2016 Aug;55(4):472-9.
- Wang PH, Horng HC, Chen CP. Is it safe to use minimally invasive surgery in the management of endometrial cancer? Taiwan J Obstet Gynecol. 2016 Apr;55(2):155-6.
- Amant F, Floquet A, Friedlander M et al. Gynecologic Cancer InterGroup (GCIG) consensus review for endometrial stromal sarcoma. Int J Gynecol Cancer 2014 Nov; 24(9 Suppl 3):S67-72.
- ESMO/European Sarcoma Network Working Group. Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25 2014: iii102-iii112.
- Ayhan A, Toptaş T, Oz M et al. Low-grade endometrial stromal sarcoma: A Turkish uterine sarcoma group study analyzing prognostic factors and disease outcomes. Gynecol Oncol 160.3 2021: 674-680.
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Case Report |
| Authors | |
| Early Pub Date | March 29, 2022 |
| Publication Date | March 29, 2022 |
| Acceptance Date | December 29, 2021 |
| Published in Issue | Year 2022 Volume: 4 Issue: 1 |
