Endometrial stromal sarcoma in combination with mixed type endometrial carcinomas

Abstract

Rationale:Endometrial stromal sarcoma (ESS) is rare, representing only approximately 0.2% of all uterine malignancies. Mixed type endometrial carcinomas (MT-ECs) are rare tumors with both type I and II features, and are difficult to diagnose. Cases of ESS and MT-ECs coexisting in the same patient are extremely rare. This study aimed to describe a case of ESS in combination with MT-ECs in a 47-year-old premenopausal woman.Patient concerns:A woman presented to the hospital complaining of occasional abdominal pain and had high tumor markers: cancer antigen (CA) 19–9 (263.6 U/mL) and CA 125 (428.0 U/mL). Transvaginal ultrasound examination revealed a complex mass (12.3 × 9.1 × 6.3 cm) with solid and cystic components on the right rear wall of the uterus. Abdominopelvic computed tomography images showed a pelvic cystic-solid mixed mass. The patient underwent an exploratory midline laparotomy. The mass was hypothesized to be malignant on the uterine posterior wall. Tumor deposits were found on bilateral parametrium. On peritoneal implantation, multiple metastases were seen on the serosal surface of the bowel and greater omentum. A frozen section revealed a spindle cell sarcoma.Diagnoses:Pathological reports following surgery revealed concurrent ESS and MT-ECs.Interventions:The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, and macroscopic clearance of the tumor. Adjuvant chemotherapy was given.Outcomes:The patient was still alive when this report was written.Lessons:Considering the rarity of ESS in combination with MT-ECs, this study presented an overview of the literature and discussed a number of histological and clinical issues. Nevertheless, etiology and pathogenesis of these tumors need further investigation.

Machine Learning Identifies Robust Matrisome Markers and Regulatory Mechanisms in Cancer

“…This is of particular interest, since RUNX3 is a paradoxical oncogene in HNSC (while generally being a tumor suppressor) and is connected to the transforming growth factor b (TGF-b) pathway and fibrosis [33,34], thus suggesting that the activation of this regulatory interaction plays a significant role in the microenvironmental characteristics of this neoplasia. In keeping with these findings, we evidence that SEMA4D is also found by our analysis in Uterine Corpus Endometrial Carcinoma (UCEC), in this case regulated by Paired box gene 8 (PAX8 , Table S1) which is a driver of uterine neoplasms and, again, associates with fibrosis [35,36].…”

A case of ovarian carcinosarcoma composed of endometrioid carcinoma and endometrial stromal sarcoma

“…We experienced a case combining EC and ESS, which has not been described in many reports as summarized in Table 1. [6][7][8][9] EC arises most commonly in the perimenopausal or postmenopausal age group, in the fifth and sixth decades of life, with a mean age of 56 years. 10 It has been suggested that a high proportion of ovarian ECs arise from endometriotic cysts, since ipsilateral ovarian and pelvic endometriosis is seen in up to 42% of ECs.…”

High-grade Endometrial Stromal Sarcoma With BCOR Gene Alterations is Recommended as an Independent Subtype of Endometrial Carcinoma: A Case Report

“…Among them, uterine leiomyosarcoma is the most universal malignant mesenchymal tumor, accounting for 1% of uterine malignant tumor (1). ESS accounts for 0.2% of malignant uterine tumors (2). The coexistence of these two kinds of malignant tumours in one patient is extremely rare, especially when the volume of ESS accounts for less than 1% of the tumour mass but causes ovarian and pelvic metastases.…”