Endometrial stromal sarcoma arising from polypoid endometriosis: Case report and literature review.

Endometrial stromal sarcoma Endometriosis Pelvic mass Polypoid endometriosis Surgery Total pelvic exenteration

Journal

International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872

Informations de publication

Date de publication:
2020
Historique:
received: 04 04 2020
revised: 09 06 2020
accepted: 10 06 2020
entrez: 24 7 2020
pubmed: 24 7 2020
medline: 24 7 2020
Statut: ppublish

Résumé

Polypoid endometriosis (PE) is a rare and uncommon variant of endometriosis that may present as a polypoid mass that simulates a malignant neoplasm. Typically, PE develops locally as a large benign pelvic mass. However, it may sometimes conceal a malignant disease in its context. A 53 years old, nulliparous lady, had been treated over a 10-year period for recurrent and symptomatic polypoid endometriosis of the pelvis. During this time, she underwent four surgical resections, the final one being a total pelvic exenteration, with histology demonstrating the presence of a rare myxoid low grade Endometrial Stromal Sarcoma (ESS) that had arisen in PE. PE is a rare variant growth pattern of endometriosis which may involve different pelvic organs and can mimic a malignant mass in the pelvis. It mostly affects women in their peri- or post-menopausal age and it is not always related to hormonal therapy. Malignances, such as Endometrial Stromal Sarcoma in this case, can arise in the context of PE and their diagnosis can be challenging. Surgical excision may constitute radical multi-organ resection, particularly for recurrent and symptomatic cases. However, the recurrence rates after surgery can be significant.

Sections du résumé

BACKGROUND BACKGROUND
Polypoid endometriosis (PE) is a rare and uncommon variant of endometriosis that may present as a polypoid mass that simulates a malignant neoplasm. Typically, PE develops locally as a large benign pelvic mass. However, it may sometimes conceal a malignant disease in its context.
CASE PRESENTATION METHODS
A 53 years old, nulliparous lady, had been treated over a 10-year period for recurrent and symptomatic polypoid endometriosis of the pelvis. During this time, she underwent four surgical resections, the final one being a total pelvic exenteration, with histology demonstrating the presence of a rare myxoid low grade Endometrial Stromal Sarcoma (ESS) that had arisen in PE.
CONCLUSION CONCLUSIONS
PE is a rare variant growth pattern of endometriosis which may involve different pelvic organs and can mimic a malignant mass in the pelvis. It mostly affects women in their peri- or post-menopausal age and it is not always related to hormonal therapy. Malignances, such as Endometrial Stromal Sarcoma in this case, can arise in the context of PE and their diagnosis can be challenging. Surgical excision may constitute radical multi-organ resection, particularly for recurrent and symptomatic cases. However, the recurrence rates after surgery can be significant.

Identifiants

pubmed: 32698283
pii: S2210-2612(20)30465-X
doi: 10.1016/j.ijscr.2020.06.062
pmc: PMC7327825
pii:
doi:

Types de publication

Case Reports

Langues

eng

Pagination

537-540

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Références

Am J Surg Pathol. 2002 Oct;26(10):1243-58
pubmed: 12360039
J Clin Pathol. 2010 May;63(5):452-4
pubmed: 20299388
Int J Surg. 2018 Dec;60:132-136
pubmed: 30342279

Auteurs

Fabio Carbone (F)

Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK; Department of Advanced Biomedical Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy. Electronic address: fa.carbone87@gmail.com.

Manou Manpreet Kaur (MM)

Department of Gynaecological Oncology, The Royal Marsden Hospital, London, UK. Electronic address: manou.m.kaur@gmail.com.

Aik Yong Chok (AY)

Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK. Electronic address: chokaikyong@gmail.com.

Christos Kontovounisios (C)

Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK; Departments of Surgery and Cancer, Imperial College, London, UK; Department of Colorectal Surgery, Chelsea and Westminster Hospital, London, UK. Electronic address: c.kontovounisios@imperial.ac.uk.

Thomas Ind (T)

Department of Gynaecological Oncology, The Royal Marsden Hospital, London, UK. Electronic address: thomasind@me.com.

Shahnawaz Rasheed (S)

Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK. Electronic address: shahnawaz.rasheed@rmh.nhs.uk.

Classifications MeSH