Abstract

Endometrial stromal sarcoma is a rare and controversial neoplasm composing of proliferative mesenchymal cells resembling those of the endometrial stroma. There are two types of endometrial stromal sarcoma; a low-grade type known as endolymphatic stromal myosis, and a frankly malignant form known as stromal sarcoma. The former is low-grade, slow-growing sarcoma that may recur locally but rarely metastasizes, whereas the latter has rapid local progression with early distant metastasis. We experienced a case of low-grade endometrial stromal sarcoma in a 39-year-old female with chief complaint of intermittent lower abdominal pain and irregular vaginal bleeding. The uterus of the patient was removed under impression of uterine rnyoma. Grossly, the tumor is a slightly elliptical myometrial mass measuring 6.5cm in larger diameter and is situated mainly in right and posterior wall of the uterus. The free surface of the tumor to the uterine cavity is multiple polypoid. The cut surface is gray to pink, relatively well demarcated but focally infiltrative, firm, and fibrous trabecular. The tumor is not encapsulated and do not compress surrounding myometrium. Microscopically, the tumor is composed of masses of oval or spindle mesenchymal cells closely resembled the endometrial stromal cell in areas between the myometrial muscle bundles and in blood vessels and lymphatics largely dilated. Mitotic figures are rare and cellular atypic is less. A clinicopathologic observation of this case was discussed with a brief review of literature on this entity.