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treatment of endometrial stromal sarcoma

Allison J Allen, Siraj M Ali, Kyle Gowen, Julia A Elvin, Tanja Pejovic
•Genomic alterations may improve diagnostic certainty and subsequent treatment of endometrial stromal sarcoma.•Novel JAZF1-BCORL1 mutation was identified.•Targeted therapeutics to down-stream targets may improve survival benefit in these patients.
May 2017: Gynecologic Oncology Reports
Jing-Yi Chern, Leslie R Boyd, Stephanie V Blank
Uterine sarcomas are rare malignant uterine neoplasms that are responsible for a large majority of uterine cancer-associated deaths. The subtypes include leiomyosarcomas, endometrial stromal tumors, and adenosarcomas. Standard treatment includes complete surgical resection. Adjuvant treatment with chemotherapy, hormonal therapy, or radiation may be considered in patients with high-risk disease. However, because the ability of adjuvant treatment to improve overall survival in patients with uterine sarcomas is unclear, there is no standard recommendation regarding adjuvant therapy...
March 15, 2017: Oncology (Williston Park, NY)
Matthias Barral, Vinciane Placé, Raphaël Dautry, Sandra Bendavid, Françoise Cornelis, Romain Foucher, Youcef Guerrache, Philippe Soyer
Uterine myometrial tumors are predominantly benign conditions that affect one-third of women and represent the main indication for hysterectomy. Preoperative imaging is of utmost importance for characterization and for precise mapping of myometrial tumors to best guide therapeutic strategy. New minimally invasive therapeutic strategies including morcellation, myolysis, uterine artery embolization and image-guided radiofrequency or focused ultrasound ablation have been developed for the treatment of uterine leiomyoma...
February 28, 2017: Abdominal Radiology
Michael J Halaska, Dimitrios Haidopoulos, Frédéric Guyon, Philippe Morice, Ignacio Zapardiel, Vesna Kesic
Recently, there has been an intense discussion about the issue of fibroid and uterine morcellation in relation to the risk of unrecognized uterine sarcoma spread. Morcellation can negatively influence the prognosis of patients, and transecting the specimen into pieces prevents the pathologist from performing proper disease staging. Many societies have published their statements regarding this issue. The European Society for Gynecological Oncology has established a working group of clinicians involved in diagnostics and treatment of oncogynecological patients to provide a statement from the oncological point of view...
January 2017: International Journal of Gynecological Cancer
Kohei Nakamura, Kentaro Nakayama, Masako Ishikawa, Noriyoshi Ishikawa, Hiroshi Katagiri, Atsuko Katagiri, Tomoka Ishibashi, Emi Sato, Kohji Iida, Razia Sultana, Satoru Kyo
Low-grade endometrial stromal sarcoma (LGESS) is a rare malignancy. The tumor is reportedly responsive to hormonal therapy, most commonly with medroxyprogesterone acetate (MPA), but the effectiveness of aromatase inhibitors for recurrent LGESS remains unclear. The present study reports a case of stage IC LGESS presenting with abnormal uterine bleeding, and also provides a review of the literature. Following a total abdominal hysterectomy and bilateral salpingo-oophorectomy, MPA therapy was initiated; treatment was successful, but discontinued 19 months later due to disruptive side effects...
November 2016: Oncology Letters
Deanna Wan Jie Ng, Grace Hwei Ching Tan, Claramae Shulyn Chia, Cindy Xindi Lim, Soo Khee Chee, Richard Hong Hui Quek, Mohamad Farid, Melissa Ching Ching Teo
AIM: A nomogram for prediction of 12-year sarcoma-specific survival has been developed based on patients with soft tissue sarcomas treated in Memorial Sloan Kettering Cancer Centre (MSKCC). We aim to evaluate the predictive accuracy of the MSKCC sarcoma nomogram in a cohort of patients treated at an Asian institution. This has not been validated in an Asian population and thus its universal applicability remains unproven. MATERIALS AND METHODS: Between 1990 and 2013, 840 adult patients underwent treatment for primary soft tissue sarcoma (STS) at the National Cancer Centre Singapore...
November 21, 2016: Asia-Pacific Journal of Clinical Oncology
Masjensen Argadjendra, Nariman Ahmadi, Celi Varol
Endometrial Stromal Sarcomas are rare malignant tumours of the uterus. We report the case of incidental finding of Low-Grade Endometrial Stromal Sarcoma (LGESS) that metastasized to the retroperitoneum 14 years after the original surgery in a 72-year-old woman. The patient underwent a laparotomy and excision of all tumour nodules. Considering the common recurrence of and slow growing nature of LGESS, appropriate treatment options like surgical excision and life-long follow up should be considered.
November 2016: Urology Case Reports
Weimin Xie, Dongyan Cao, Jiaxin Yang, Xuan Jiang, Keng Shen, Lingya Pan, Huifang Huang, Jinghe Lang, Yan You, Jie Chen
PURPOSE: To assess the clinical outcomes and fertility of young women with stage I low-grade endometrial stromal sarcoma (ESS) treated with fertility-sparing surgery. RESULTS: Seventeen patients with stage I low-grade ESS (stage IA, n = 6; stage IB, n = 11) were entered into this study. Adjuvant hormone therapy was administered to 15 (88.2%) patients. At a median follow-up of 39 months (range, 4-106 months), 10 (58.8%) patients developed recurrence. All 10 patients had stage IB disease; among them, the first recurrence limited to the uterus was observed in 6 patients...
February 7, 2017: Oncotarget
Krystyna Serkies, Ewa Pawłowska, Jacek Jassem
Uterine endometrial stromal sarcomas including true low-grade endometrial stromal sarcoma (LG-ESS) and high-grade (HG-ESS) or undifferentiated endometrial sarcoma (UES) constitute a group of rare, aggressive malignancies. Most LG-ESSs express steroid receptors. Surgery is the principal primary therapy for endometrial stromal sarcomas and should be considered in all cases. These malignancies are relatively radio- and chemoresistant. Chemotherapy is used in recurrent and advanced HG-ESS and UES. Currently, the combination of gemcitabine and docetaxel is considered the most effective regimen, but at the expense of substantial toxicity...
2016: Ginekologia Polska
Mauro Cozzolino, Dimitrios Nasioudis, Giovanni Sisti, Maria Elisabetta Coccia
BACKGROUND: The study aimed to examine all available evidence regarding primary vaginal cancer arising from endometriosis from an evidence-based perspective. METHODS: A literature search in Medline and EMBASE databases was conducted. The following key words were employed: 'vaginal cancer' AND 'endometriosis malignant transformation' OR 'endometriosis'. RESULTS: A total of 23 eligible studies were identified and included in the present review providing information for 37 patients...
2017: Gynecologic and Obstetric Investigation
S Sivakumari, R Rajaraman, S Subbiah
Uterine sarcomas are rare, highly malignant tumours comprising < 1 % of all gynaecologic malignancies. To evaluate clinical presentation, histolopathologic pattern and outcome of uterine sarcomas presenting to a tertiary referral centre over an 8 year period (2004-2012). All histologically proven uterine sarcomas were retrospectively analysed. Clinical presentation, histology, treatment and outcome were analysed. Mean age was 42 years. Predominant histopathology was endometrial stromal sarcoma (n = 13); 9 were low grade, carcinosarcoma (n = 8) and leiomyosarcoma (n = 2)...
September 2015: Indian Journal of Surgical Oncology
Min-Hyun Baek, Jeong-Yeol Park, Chae Chun Rhim, Yangsoon Park, Kyu-Rae Kim, Jong-Hyeok Kim, Joo-Hyun Nam
AIM: Endometrial stromal sarcoma (ESS) is a rare tumor with limited treatment options. Histone deacetylase (HDAC) is a potential therapeutic target in ESS showing a good rate of response in laboratory studies. In this study we investigated the expression of HDAC enzymes in 41 ESS patients. MATERIALS AND METHODS: Immunohistochemical expression of HDACs was analyzed by tissue microarrays. RESULTS: Strong positive immunoreactivity was observed in 32 (78...
May 2016: Anticancer Research
Yuya Nogami, Yoko Fujii-Nishimura, Kouji Banno, Atsushi Suzuki, Nobuyuki Susumu, Taizo Hibi, Koji Murakami, Taketo Yamada, Hiromu Sugiyama, Yasuyuki Morishima, Daisuke Aoki
BACKGROUND: We report two cases of anisakiasis lesions that were initially suspected to be recurrence of gynecological cancer by positron emission tomography-computed tomography (PET-CT). Both cases were extragastrointestinal anisakiasis that is very rare. CASE PRESENTATION: The first case was a patient with endometrial cancer. At 19 months after surgery, a new low density area of 2 cm in diameter in liver segment 4 was found on follow-up CT. In PET-CT, the lesion had abnormal (18)fluoro-deoxyglucose (FDG) uptake with elevation in the delayed phase, with no other site showing FDG uptake...
April 26, 2016: BMC Medical Imaging
Heather Wolfe, Kristen Bunch, Michael Stany
BACKGROUND: Endometrial stromal sarcomas (ESSs) are rare, indolent tumors with high recurrence rates. Management includes surgery and hormonal therapy given high estrogen and progesterone receptor (ER/PR) expression. CASE: A pre-menopausal patient with stage II ESSs (ER +/PR +) underwent primary surgery followed by adjuvant megestrol. Recurrence in the bladder/upper vagina (ER +/PR -) was diagnosed one year later and treated with anterior pelvic exenteration and adjuvant letrozole...
January 2016: Gynecologic Oncology Reports
Hyewon Ryu, Yoon-Seok Choi, Ik-Chan Song, Hwan-Jung Yun, Deog-Yeon Jo, Samyong Kim, Hyo Jin Lee
Endometrial stromal sarcoma (ESS) occurs rarely and accounts for only 0.2% of all uterine malignancies. ESS usually expresses estrogen and progesterone receptors, and is regarded as hormone-sensitive. Due to the rarity of these tumors, there are only few case series on the use of aromatase inhibitors in the treatment of low-grade ESS. The present study reports the cases of two patients with residual or recurrent low-grade ESS who experienced long-term disease-free survival following treatment with letrozole...
November 2015: Oncology Letters
Stefanie Burghaus, Sonja Halmen, Paul Gass, Grit Mehlhorn, Michael G Schrauder, Michael P Lux, Stefan P Renner, Matthias W Beckmann, Alexander Hein, Falk C Thiel
PURPOSE: There is low evidence regarding the optimal treatment in patients with uterine sarcomas and malignant mixed Mullerian tumors (MMMTs). This study provides an overview of experience at our center with patients diagnosed with uterine sarcoma and MMMT, in relation to the clinical management and outcome. METHODS: The medical records for 143 patients with low-grade endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), and high-grade (undifferentiated) endometrial sarcoma (UES) and MMMT were reviewed...
August 2016: Archives of Gynecology and Obstetrics
Gaya Spolverato, Elizabeth Montgomery, Ihab Kamel, Timothy M Pawlik
Endometrial stromal sarcoma (ESS) represents only 0.2% of all uterine malignancies. Even fewer cases have been reported on patients presenting with symptomatic disease. We report the case of young lady presenting with a large bleeding abdominal mass. At the time of surgery, an en bloc excision of the mass with a partial pancreatectomy, splenectomy, transverse colectomy, left nephrectomy, left adrenalectomy and resection of the diaphragm was performed. The final pathology revealed a malignant spindle and epithelial cell neoplasm with features favoring a variant of ESS...
October 2015: Hepatobiliary Surgery and Nutrition
Óscar Ernesto Cárdenas-Serrano, José Sebastián Villalón-López, Gabriela Ruiz-Mar, Leonel Daza-Benítez
BACKGROUND: Uterine sarcomas are rare but extremely aggressive malignant uterine pathology; mostly incidentally diagnosed at an advanced stage, with a higher aggressiveness and poor prognosis. OBJECTIVE: To determine the epidemiological profile of women with this diagnosis in Ginecopediatria Hospital, UMAE 48 of IMSS and its correlation with the literature. MATERIAL AND METHODS: A retrospective and observational study was done from 2007 to 2014 in UMAE 48, IMSS León, Guanajuato, in which the clinical records of patients with such diagnoses were reviewed...
September 2015: Ginecología y Obstetricia de México
Tine Cuppens, Sandra Tuyaerts, Frédéric Amant
Uterine sarcomas are rare tumors accounting for 3,4% of all uterine cancers. Even after radical hysterectomy, most patients relapse or present with distant metastases. The very limited clinical benefit of adjuvant cytotoxic treatments is reflected by high mortality rates, emphasizing the need for new treatment strategies. This review summarizes rising potential targets in four distinct subtypes of uterine sarcomas: leiomyosarcoma, low-grade and high-grade endometrial stromal sarcoma, and undifferentiated uterine sarcoma...
2015: Sarcoma
N Suciu, I Bălescu, N Bacalbaşa
Endometrial stromal sarcomas are rare gynecologic malignancies characterized by the presence of cells that resemble those of the endometrial stroma during the prolipferative phase of the menstrual cycle. They are classified as low grade or high grade tumors depending on the mitotic index, the second one being usually associated with poor prognosis and high recurrence rate. We present the case of a 46-year-old patient who was previously submitted to surgery for an endometrial stromal sarcoma followed by adjuvant radiotherapy; 18 months later she was diagnosed with a pelvic recurrence invading the urinary bladder trigone and the rectosigmoid so she was submitted to a total pelvic exenteration...
September 2015: Chirurgia
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