Low-grade endometrial stromal sarcoma. Case report and literature review

Introduction: Uterine sarcomas represent approximately 1% of all neoplasms of the female genital tract and 3-7% of all uterine neoplasms. Low-grade endometrial stromal sarcomas (ESS) are characterized by tumors with good prognosis and high survival with early diagnosis and treatment. Case report: A case of a 51-years-old woman controlled by the gynecology department with abnormal uterine bleeding secondary to endometrial hyperplasia is reported; abdominal total hysterectomy was performed with definitive histopathological report of low-grade ESS. Tumor immunohistochemistry showed positivity for CD10, vimentin and hormonal receptors; as well as low Ki67 activity and negativity for actin and desmin. Discussion: Low-grade ESS occurs in women between 40 and 55 years, and more than 50% of cases in premenopausal women. Microscopically, it is characterized by cells immunologically reactive to CD10, estrogen, progesterone, and androgens receptors. Magnetic resonance imaging shows an endometrial polypoid mass with vascular and hematogenous invasion. The treatment of choice is surgical, consisting of a radical hysterectomy with bilateral salpingo-oophorectomy. Conclusion: Low-grade ESS is one of the stromal neoplasms with better prognosis and survival. It is of the utmost importance the early diagnosis and treatment, with the use of new therapies and immunohistochemical markers, that allow to offer a greater survival to the patients with this disease.