Primary Ovarian Endometrioid Stromal Sarcoma Presenting with Infertility

Abstract

A 34-year-old woman came to gynaecology outpatient department with the complaint of infertility. She was married for 10 years. Her menstrual cycles were regular but were associated with dysmenorrhoea. As part of investigation for infertility, ultrasonogram was done which revealed a left ovarian tumour with adhesions. MRI showed an enhancing lesion with solid and cystic components measuring 11 cm x 9.8 cm x 6 cm in left adnexa with extensions anteriorly upto the anterior abdominal wall, posteriorly infiltrating the uterus and laterally upto the left ileus muscle. Left salphingooophorectomy was performed and specimen was sent for histopathology. Tumour arising from left ovary showed broad papillary excrescences (Tombstone appearance) with a solid, yellowish cut surface [Table/ Fig-1].

Primary ovarian endometrioid stromal sarcoma presenting with reno-ureteral colic

“…Ovarian adenosarcomas have a similar prognosis to the homonymous uterine sarcoma and have a tumour recurrence in 50% of patients, which occurs almost always within the first 5 years after surgery [ 1 , 2 , 10 ]. The 5-year overall survival rates of patients with FIGO stage I have been higher than 90% and 30% in patients with FIGO stage II, whereas patients with FIGO stage III and stage IV have worse survival rates, that is, 50% [ 4 , 11 ].…”

“…Endometrioid Stromal Sarcomas (ESS) are rare mesenchymal tumours that can occur in women across a wide range of age, from puberty to menopause, taking place around a median age of 50 years, and that represents only 0.2% of all female genital tract tumors and 15–26% of primary uterine sarcomas [ 1 – 8 ].…”