Clinicopathologic features, diagnosis and treatment with extrauterine stromal sarcoma
CHEN Yanmei1, CHEN Guorong2, YANG Xiaomin1, PAN Dan1.
1.Deparment of Pathology, the Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, 325000; 2.Deparment of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015
CHEN Yanmei,CHEN Guorong,YANG Xiaomin, et al. Clinicopathologic features, diagnosis and treatment with extrauterine stromal sarcoma[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(9): 666-669.
Abstract：Objective: To study the clinicopathologic and immunohistochemical features, biological behavior, diagnosis and treatment of extrauterine stromal sarcoma (ESS). Methods: A retrospective clinicopathologic analysis was made on 10 cases of ESS admitted to the Third Clinical Institute Affiliated to Wenzhou Medical University and the First Affiliated Hospital of Wenzhou Medical University from April 1998 to September 2012. Results: Among 10 patients, 9 had low-grade ESS and 1 had extrauterine undifferentiated endometrial sarcoma (EUES). 6 tumors located in the ovary, while the other 4 cases involved bilateral ovaries/uterine rectum nest, the right ovary/genital vein/inferior vena cava, the left ovary/retroperitoneal and fallopian tube respectively. The clinical manifestations were mainly abdominalgia, abdominal mass and algomenorrhea, 5 patients had endometriosis. The others were alive until the end of follow-up time. Immunohistolochemically, CD10 (8/10), Estrogen receptor (5/10), Progesterone receptor (9/10), Smooth muscle actin (5/10), Desmin (2/10), Caldesmon (1/10), All 10 patients were treated with complete surgical resection and received postoperative adjuvant therapy. The follow-up time for all patients ranged from 19~127 months. 5 patients had one or more recurrences, the time of first recurrences was within 2 years. 2 of 5 patients died of multiple recurrences including 1 EUES. Conclusion: ESS which is the most common in ovary is an extremely rare neoplasm. Most of them are associated with endometriosis. The preferred therapy is complete excision and postoperative adjuvant therapy. ESS with low-grade had one or more replases easily in short time, but the patients should be alive for a long time. CD10 as immunohistochemical marker is specific.
