Low-grade endometrial stromal sarcoma: a case report and literature review
BackgroundLow-grade endometrial stromal sarcoma (LG-ESS) is a rare malignant tumor of the female reproductive system with atypical clinical symptoms and slow progression.CaseA 44-year-old female with a history of intermittent severe dysmenorrhea, previous laparoscopic myomectomy, and uterine artery...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1652010/full |
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| author | Xiaojing Zhao Chuqiao Chen Chuqiao Chen Tingting Xie Liang Wang |
| author_facet | Xiaojing Zhao Chuqiao Chen Chuqiao Chen Tingting Xie Liang Wang |
| author_sort | Xiaojing Zhao |
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| description | BackgroundLow-grade endometrial stromal sarcoma (LG-ESS) is a rare malignant tumor of the female reproductive system with atypical clinical symptoms and slow progression.CaseA 44-year-old female with a history of intermittent severe dysmenorrhea, previous laparoscopic myomectomy, and uterine artery embolization (UAE) presented with rapidly enlarging pelvic masses. Imaging revealed uterine masses suggestive of leiomyomas, although an adnexal origin could not be excluded. Laparoscopy showed an irregularly enlarged uterus with widespread pelvic masses. Postoperative pathology and immunohistochemistry confirmed a diagnosis of LG-ESS with focal sex cord-like and smooth muscle differentiation. The patient underwent total hysterectomy and bilateral salpingo-oophorectomy, with subsequent recommendations for aromatase inhibitor therapy and lifelong follow-up. The 3-month post-surgery follow-up results indicated that the patient was recovering well, with no signs of recurrence.ConclusionBy reviewing the patient’s medical history, we gained new insights into the etiology, risk factors, and imaging characteristics of LG-ESS. Endometriotic lesions may serve as a source of LG-ESS. The use of morcellators and UAE in the treatment of benign uterine conditions can increase the risk of malignant tumors. Distinguishing LG-ESS on imaging can be challenging, but magnetic resonance imaging shows some suggestive features, including isointense or slightly hypointense signals on T1-weighted imaging, a mixed signal on T2-weighted imaging or a homogeneous high signal with internal hypointense bands, a high signal on diffusion-weighted imaging, and low apparent diffusion coefficient values, which may aid in differentiation. |
| format | Article |
| id | doaj-art-3d582ea6035e47179d4e6420e4ebeec2 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-3d582ea6035e47179d4e6420e4ebeec22025-08-25T04:10:23ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16520101652010Low-grade endometrial stromal sarcoma: a case report and literature reviewXiaojing Zhao0Chuqiao Chen1Chuqiao Chen2Tingting Xie3Liang Wang4Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaSecond Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaShulan Hangzhou Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, ChinaSecond Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaSecond Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaBackgroundLow-grade endometrial stromal sarcoma (LG-ESS) is a rare malignant tumor of the female reproductive system with atypical clinical symptoms and slow progression.CaseA 44-year-old female with a history of intermittent severe dysmenorrhea, previous laparoscopic myomectomy, and uterine artery embolization (UAE) presented with rapidly enlarging pelvic masses. Imaging revealed uterine masses suggestive of leiomyomas, although an adnexal origin could not be excluded. Laparoscopy showed an irregularly enlarged uterus with widespread pelvic masses. Postoperative pathology and immunohistochemistry confirmed a diagnosis of LG-ESS with focal sex cord-like and smooth muscle differentiation. The patient underwent total hysterectomy and bilateral salpingo-oophorectomy, with subsequent recommendations for aromatase inhibitor therapy and lifelong follow-up. The 3-month post-surgery follow-up results indicated that the patient was recovering well, with no signs of recurrence.ConclusionBy reviewing the patient’s medical history, we gained new insights into the etiology, risk factors, and imaging characteristics of LG-ESS. Endometriotic lesions may serve as a source of LG-ESS. The use of morcellators and UAE in the treatment of benign uterine conditions can increase the risk of malignant tumors. Distinguishing LG-ESS on imaging can be challenging, but magnetic resonance imaging shows some suggestive features, including isointense or slightly hypointense signals on T1-weighted imaging, a mixed signal on T2-weighted imaging or a homogeneous high signal with internal hypointense bands, a high signal on diffusion-weighted imaging, and low apparent diffusion coefficient values, which may aid in differentiation.https://www.frontiersin.org/articles/10.3389/fonc.2025.1652010/fullcase reportlow-grade endometrial stromal sarcomalaparoscopic power morcellationmagnetic resonance imaginguterine artery embolization |
| spellingShingle | Xiaojing Zhao Chuqiao Chen Chuqiao Chen Tingting Xie Liang Wang Low-grade endometrial stromal sarcoma: a case report and literature review Frontiers in Oncology case report low-grade endometrial stromal sarcoma laparoscopic power morcellation magnetic resonance imaging uterine artery embolization |
| title | Low-grade endometrial stromal sarcoma: a case report and literature review |
| title_full | Low-grade endometrial stromal sarcoma: a case report and literature review |
| title_fullStr | Low-grade endometrial stromal sarcoma: a case report and literature review |
| title_full_unstemmed | Low-grade endometrial stromal sarcoma: a case report and literature review |
| title_short | Low-grade endometrial stromal sarcoma: a case report and literature review |
| title_sort | low grade endometrial stromal sarcoma a case report and literature review |
| topic | case report low-grade endometrial stromal sarcoma laparoscopic power morcellation magnetic resonance imaging uterine artery embolization |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1652010/full |
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