Undifferentiated Stromal Sarcoma
About: Undifferentiated Stromal Sarcoma is a(n) research topic. Over the lifetime, 6 publication(s) have been published within this topic receiving 58 citation(s).
TL;DR: The key issues that will be discussed include the prognostic relevance of pathological and biological variables other than tumour stage in the different histological subtypes of uterine sarcoma.
Abstract: Uterine sarcomas usually have an aggressive clinical behaviour, with great tendency to local and distant spread, with unfavourable clinical outcome, excluding endometrial stromal sarcomas and adenosarcoma. Tumour stage is the strongest prognostic factor for all uterine sarcomas, with 5-year survival of about 50–55% for stage I and 8–12% for more advanced stages. Multivariate analysis of some studies have shown that women with leiomyosarcoma have a poorer survival than those with carcinosarcoma. The key issues that will be discussed include the prognostic relevance of pathological and biological variables other than tumour stage in the different histological subtypes of uterine sarcoma. Immunomarkers for cell proliferation and apoptosis have been tested for the identification of tumours with different clinical behaviour, but they are still subject to research and are not currently used in clinical practice.
TL;DR: In 4 cases of malignant undifferentiated stromal sarcoma, flow-cytometric analysis does not always agree with the biological properties of the tumour and the clinical behaviour, in contrast to the results obtained in respect of carcinomas.
Abstract: Only 0.2-1% of all mammary malignancies are sarcomas of the breast. This study includes 4 cases: 2 osteosarcomas, 1 fibrosarcoma, and 1 malignant undifferentiated stromal sarcoma. The therapy was mastectomy in 3 cases with dissection of axillary lymph nodes and simple mastectomy in one case. One patient demonstrated local recurrence and died. The remaining 3 patients developed neither metastases nor local recurrence. They are still alive after a follow-up period of between 18 months and 17 years. As first-line treatment, wide local excision or simple mastectomy is recommended. Dissection of the axillary lymphatics, adjuvant radiotherapy, or chemotherapy have no established value in the treatment of breast sarcoma. In our 4 cases, flow-cytometric analysis does not always agree with the biological properties of the tumour and the clinical behaviour, in contrast to the results obtained in respect of carcinomas.
TL;DR: The first case of undifferentiated ESS (UES) coexistent with grade 1 endometrioid adenocarcinoma in a 73-year-old female who presented with irregular vaginal bleeding for 4 days after menopause 20 years is reported.
Abstract: Endometrial stromal sarcoma (ESS) is a rare malignant neoplasm of the uterus. We report the first case of undifferentiated ESS (UES) coexistent with grade 1 endometrioid adenocarcinoma in a 73-year-old female who presented with irregular vaginal bleeding for 4 days after menopause 20 years. Imaging examination including Magnetic Resonance Imaging (MRI) demonstrated multi-node reflection in uterine cavity without metastatic lesions, and the endometrium essentially normal. Grossly, a grey-red breakable polypoid tumor of 4.5 × 3.0 ×2.0 cm was recognized in the posterior uterine wall with surrounding slight rough endometrium. Microscopically, the tumor was composed of a larger component of undifferentiated stromal sarcoma that was distinct from a smaller endometrioid adenocarcinoma. The separate components of the tumor could be supported in immunohistochemical studies. There was no sign of recurrence for postoperative 6 months.
••01 Jan 2013
TL;DR: The three nonleiomyosarcoma tumors, (low-grade) endometrial stromal sarcoma, high-grade undifferentiated stroma, and mixed Mullerian tumors including carcinosarcomA are all very different from one another biologically.
Abstract: Beyond leiomyosarcoma, uterine sarcomas and tumors that contain “sarcoma” in the name (ie, carcinosarcoma) are well-recognized biological entities The three nonleiomyosarcoma tumors, (low-grade) endometrial stromal sarcoma, high-grade undifferentiated stromal sarcoma, and mixed Mullerian tumors including carcinosarcoma, are all very different from one another biologically They are often omitted in discussions of soft tissue pathology as different groups of pathologists generally review such cases in expert centers than those who review soft tissue or bone tumors Age distribution for adult uterine endometrial stromal tumors is shown in Fig 211
01 Jan 2020-Journal of Mid-life Health
TL;DR: It is important for all clinicians to keep the high degree of suspicion for ESS while working up any case of abnormal uterine bleeding, and it is important to have preoperative histopathological diagnosis of ESS.
Abstract: Endometrial stromal sarcoma (ESS) is a rare malignant tumor that constitutes about 0.2% of all uterine malignancies and 10% of uterine sarcomas. ESS is generally misdiagnosed as leiomyoma or endometrial polyp and typically discovered on histopathological examination postoperatively because of its rarity. Endometrial stromal tumors are composed of cells resembling normal endometrial stroma in its proliferative phase. The histologic diagnosis of the high grade is made if there is a high-grade sarcoma with a high mitotic index and nuclear anaplasia. The mean age of presentation of high-grade endometrial sarcoma is about 61 years with the most common presenting complaint is menorrhagia. The median overall survival for high-grade endometrial sarcoma is 53 months with optimal cytoreduction. A 49-year-old woman P2 L2 presented with nonspecific complaint of discharge and spotting per vaginum. In the present case, the provisional diagnosis by clinical findings as well as imaging was in favor of the inversion of submucous fibroid. Preoperative histopathological examination and immunohistochemistry confirmed the diagnosis of high-grade undifferentiated ESS. Haultain's operation followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. The patient was referred to another center for radiotherapy. From there, she was lost to follow-up. Rarity of endometrial stromal tumor limits the clinician view to diagnose it preoperatively. We were fortunate to have preoperative histopathological diagnosis of ESS. Furthermore, as ESS is rare and undifferentiated stromal sarcoma is even rarer, literature is lacking on its optimal management. Hence, it is important for all clinicians to keep the high degree of suspicion for ESS while working up any case of abnormal uterine bleeding.
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