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treatment of endometrial stromal sarcoma

Kenichi Nakamura, Hiroaki Kajiyama, Fumi Utsumi, Shiro Suzuki, Kaoru Niimi, Ryuichiro Sekiya, Jun Sakata, Eiko Yamamoto, Kiyosumi Shibata, Fumitaka Kikkawa
Uterine sarcomas are some of the most malignant and aggressive tumor types among the gynecologic malignancies, and they are associated with a high rate of recurrence and a poor prognosis. Due to their rarity and diversity, the optimal treatment for recurrent uterine sarcomas has not yet been elucidated. The aim of the present study was to investigate the potential of secondary cytoreductive surgery (SCS) for patients with recurrent uterine sarcomas. A total of 18 patients with recurrent uterine sarcomas were retrospectively identified at the Department of Obstetrics and Gynecology, Nagoya University (Nagoya, Japan) between January 2002 and December 2015...
March 2018: Molecular and Clinical Oncology
L E Stewart, T L Beck, N V Giannakopoulos, M H Rendi, C Isacson, B A Goff
OBJECTIVES: Low grade endometrial stromal sarcoma (LG-ESS) is a rare cancer with an indolent course. We aimed to assess the effectiveness of adjuvant hormonal suppression (HT) with or without oophorectomy (BSO) in prolonging progression free survival (PFS) and overall survival (OS) in patients with LG-ESS. METHODS: We performed a multi-institutional retrospective review of patients treated for low grade LG-ESS from 1985 to 2014. Demographics, treatment and recurrence data were abstracted from medical records...
March 11, 2018: Gynecologic Oncology
I M E Desar, P B Ottevanger, C Benson, W T A van der Graaf
Uterine sarcomas (US) are rare mesenchymal tumours of the uterus and are divided mainly into uterine leiomyosarcoma (uLMS), low grade endometrial stromal sarcoma (LG-ESS), high grade endometrial stromal sarcoma (HG-ESS), adenosarcomas and high grade undifferentiated sarcoma (HGUS). US are often high-grade tumours with a high local recurrence rate and metastatic risk. We here discuss the current standard of care and knowledge of systemic therapy for adult uterine sarcomas, in particular uLMS, LG-ESS, HG-ESS and HGUS, in both the adjuvant as well as the metastatic setting...
February 2018: Critical Reviews in Oncology/hematology
Arie J Verschoor, Fabiënne A R M Warmerdam, Tjalling Bosse, Judith V M G Bovée, Hans Gelderblom
BACKGROUND: Pazopanib is an oral tyrosine kinase inhibitor registered for metastatic renal cell carcinoma and soft tissue sarcoma. Liver toxicity is a common side effect for this class of agents. The current opinion is that in case of severe liver toxicity pazopanib should be interrupted and restarted at a lower dose after returning to Common Terminology Criteria for Adverse Events (CTCAE) grade 1. After recurrence of liver toxicity at the lower dose it is advised to permanently stop pazopanib...
January 22, 2018: BMC Cancer
Erina Yuasa-Shibasaki, Sumiyasu Ishii, Shunichi Matsumoto, Takuya Tomaru, Kazuhiko Horiguchi, Aya Osaki, Atsushi Ozawa, Nobuyuki Shibusawa, Tetsurou Satoh, Masanobu Yamada
A 39-year-old woman was admitted to our hospital with symptoms of general fatigue, nausea, and vomiting that appeared three months after she stopped seven years of medroxyprogesterone acetate (MPA) medication for endometrial stromal sarcoma. Laboratory tests demonstrated moderate hypercalcemia. Several tests demonstrated that she was suffering from adrenal insufficiency. Glucocorticoid supplementation decreased her calcium level to a normal range, indicating that hypercalcemia was induced by adrenal insufficiency...
February 15, 2018: Internal Medicine
Ghada A Abu Jamea, Ammar C Al Rikabi, Khalid Akkour
Endometrial stromal sarcoma rarely occurs as an extrauterine neoplasm and it is even more unlikely to be found in the vagina. To the best of our knowledge, only six cases of primary vaginal endometrial stromal sarcoma without association with endometriosis have been published to this day. We describe a case of a 58-year-old female with a history of vaginal heaviness caused by a mass lesion. After a biopsy was taken, the histopathological findings and immunohistochemical stains were consistent with low-grade endometrial stromal sarcoma...
November 2017: Journal of Surgical Case Reports
Hyun Jun Kim, Youjin Kim, Su Jin Lee, Jeeyun Lee, Se Hoon Park
OBJECTIVE: In the treatment of metastatic soft tissue sarcoma (STS), pazopanib is considered a standard treatment after failure of chemotherapy. We retrospectively investigated outcomes of pazopanib in patients with metastatic uterine STS. METHODS: A retrospective study was performed on 35 consecutive patients with uterine STS treated with oral pazopanib 800 mg daily as salvage therapy for metastatic disease between September 2013 and December 2015. Endpoints included response rate, survival, and safety...
January 2018: Journal of Gynecologic Oncology
Armando Sardi, Arkadii Sipok, Dario Baratti, Marcello Deraco, Paul Sugarbaker, George Salti, Yutaka Yonemura, Paolo Sammartino, Olivier Glehen, Naoual Bakrin, Teresa P Díaz-Montes, Vadim Gushchin
OBJECTIVE: Uterine sarcoma (US) is a rare tumor representing 1% of female genital tract malignancies. Peritoneal sarcomatosis (PS) after US, diminishes median overall survival (OS) and progression-free survival (PFS) with cytoreductive surgery (CRS) alone, with or without systemic chemotherapy is <1 year and 6 months, respectively. A multi-institutional review of PS from US was conducted to evaluate CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) and effects on survival outcomes...
November 2017: European Journal of Surgical Oncology
Charlotte Benson, Aisha B Miah
Uterine sarcomas comprise a group of rare tumors with differing tumor biology, natural history and response to treatment. Diagnosis is often made following surgery for presumed benign disease. Currently, preoperative imaging does not reliably distinguish between benign leiomyomas and other malignant pathology. Uterine leiomyosarcoma is the most common sarcoma, but other subtypes include endometrial stromal sarcoma (low grade and high grade), undifferentiated uterine sarcoma and adenosarcoma. Clinical trials have shown no definite survival benefit of adjuvant radiotherapy or chemotherapy and have been hampered by the rarity and heterogeneity of these disease types...
2017: International Journal of Women's Health
Omonigho Aisagbonhi, Beth Harrison, Liena Zhao, Rebecca Osgood, Ivan Chebib, Esther Oliva
Low and high-grade endometrial stromal sarcomas (ESS) can be distinguished on a morphologic basis. Low-grade ESS is composed of oval cells that resemble normal proliferative-phase endometrial stroma, while the well-known high-grade ESS is composed of round cells growing in nests separated by delicate sinusoidal vasculature. Recurrent JAZF1 rearrangements have been reported to be most frequent in low-grade stromal sarcomas (up to 60%), while YWHAE rearrangements are characteristic of high-grade ESS. Herein, we report a case of a 45-yr-old woman with stage IA typical low-grade ESS who developed multiple abdominopelvic recurrences and lung metastases 15 mo after her primary tumor was resected...
August 31, 2017: International Journal of Gynecological Pathology
Reshu Agarwal, Anupama Rajanbabu, Indu R Nair, Chandramouli Satish, Georgeena Jose, U G Unikrishnan
OBJECTIVE: To assess the factors associated with disease free survival and overall survival in endometrial stromal sarcoma (ESS). METHODS: This was a single institution retrospective analysis done at Amrita Institute of Medical Sciences. Records from January 2005 to October 2016 were analysed and 42 patients with ESS were identified. Clinicopathological, surgical management, adjuvant treatment and outcome data were collected. Disease free and overall survivals were analysed using Kaplan-Meier method and compared using log rank test...
July 14, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Brandon-Luke L Seagle, Arunima Shilpi, Samuel Buchanan, Chelain Goodman, Shohreh Shahabi
OBJECTIVE: To provide refined prognostic information from large cohorts of women with low-grade or high-grade endometrial stromal sarcoma (ESS). METHODS: We performed an observational retrospective cohort analysis of women diagnosed with low-grade or high-grade ESS from the 1998-2013 National Cancer Database. Kaplan-Meier and multivariable accelerated failure time survival analyses were performed to identify prognostic factors after multiple imputation of missing data...
August 2017: Gynecologic Oncology
Aya Kobayashi, Tamaki Yahata, Sakiko Nanjo, Mika Mizoguchi, Madoka Yamamoto, Yasushi Mabuchi, Shigetaka Yagi, Sawako Minami, Kazuhiko Ino
Large-cell neuroendocrine carcinoma (LCNEC) is a high-grade neuroendocrine tumor. LCNECs arising from the genital organs are highly malignant and rare, with <20 cases of LCNEC developing from the uterine endometrium reported to date. We herein present the case of a patient with LCNEC of the endometrium. The patient was a 52-year-old woman, who exhibited lower abdominal pain and rapid uterine enlargement during outpatient treatment for uterine myoma. The endometrial biopsy suggested a diagnosis of poorly differentiated carcinoma or carcinosarcoma...
June 2017: Molecular and Clinical Oncology
Irene Ruengkhachorn, Nisarat Phithakwatchara, Katika Nawapun, Suchanan Hanamornroongruang
OBJECTIVES: The aim of this study was to evaluate the rate, clinical characteristics, and survival outcomes of an undiagnosed uterine malignancy in patients who underwent surgical treatment for presumed leiomyomas. METHODS: Medical records of patients who underwent surgical treatment for presumed leiomyomas, from January 2004 to September 2013, were retrospectively reviewed, and the data were followed until September 2016. Demographic data, tumor characteristics, oncologic treatment, and response rate were analyzed by descriptive statistics...
June 2017: International Journal of Gynecological Cancer
Vered Buchholz, George Kiroff, Markus Trochsler, Harsh Kanhere
INTRODUCTION: Extrauterine Endometrial Stromal Sarcoma (EESS) is an extremely rare mesenchymal tumour that simulates other pathologies, and therefore poses a diagnostic challenge. This report outlines a case of EESS arising from the greater omentum mimicking a colonic tumour, with review of literature. PRESENTATION OF CASE: A 47-year-old woman, with history of hysterectomy for menorrhagia and hormone replacement therapy (HRT), presented with right sided abdominal pain and localized peritonism...
2017: International Journal of Surgery Case Reports
Lara Alessandrini, Francesco Sopracordevole, Giulio Bertola, Simona Scalone, Martina Urbani, Gianmaria Miolo, Tiziana Perin, Fabrizio Italia, Vincenzo Canzonieri
BACKGROUND: Endometrial stromal sarcomas arising in extrauterine and extraovarian sites, in the absence of a primary uterine lesion are quite rare, especially in the absence of endometriosis. They usually present as an abdominal or pelvic mass lesion. CASE PRESENTATION: In 2007, a 45-year-old woman underwent total hysterectomy for in situ squamous cell carcinoma of the cervix. In 2014, an upper left pulmonary lobectomy was performed for a mass, which was provisionally diagnosed as primary carcinosarcoma of the lung...
May 2, 2017: Diagnostic Pathology
Ran Cui, Fang Yuan, Yue Wang, Xia Li, Zhenyu Zhang, Huimin Bai
To investigate and evaluate the clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma (LG-ESS).The medical records of LG-ESS patients who were treated at 2 cancer referral centers from January 2005 to December 2015 were retrospectively reviewed.Twenty patients with LG-ESS met the inclusion criteria and were included in this analysis. Hysterectomy with bilateral salpingo-oophorectomy was the mainstay of surgery. Lymphadenectomy was performed in 12 (60%) cases, and no positive nodes were identified...
April 2017: Medicine (Baltimore)
Liselotte Mettler, Nicolai Maass, Khulkar Abdusattarova, Astrid Dempfle, Ibrahim Alkatout
OBJECTIVE: To estimate the frequency of unsuspected uterine sarcoma identified postoperatively in women undergoing surgery for presumed benign uterine fibroids at a single university hospital. MATERIAL AND METHODS: This was a retrospective single-center study; the records of all 2275 patients with uterine fibroids and uterine sarcomas from 2003 to 2015 were reviewed. Descriptive statistics were used to analyze demographic and clinical characteristics. To calculate confidence intervals (CIs), the Clopper-Pearson Exact method was applied...
June 1, 2017: Journal of the Turkish German Gynecological Association
Matthew L Hemming, Andrew J Wagner, Marisa R Nucci, Sarah Chiang, Lu Wang, Martee L Hensley, Suzanne George
OBJECTIVES: YWHAE-rearranged high-grade endometrial stromal sarcoma (HG-ESS) is a rare, recently defined uterine sarcoma harboring t(10;17)(q22;p13) resulting in YWHAE-NUTM2A/B fusion. Chemotherapy sensitivity of metastatic YWHAE-rearranged HG-ESS is unknown. We reviewed the response to chemotherapy in women with YWHAE-rearranged HG-ESS to provide guidance for clinical management. METHODS: We retrospectively identified patients diagnosed with YWHAE-rearranged HG-ESS who received treatment for metastatic disease at our institutions...
June 2017: Gynecologic Oncology
Krisztina Z Hanley, George G Birdsong, Marina B Mosunjac
There have been several updates recently on the classification of uterine tumors. Endometrial carcinomas have traditionally been divided into 2 types, but some are difficult to classify and do not fit readily into either of the currently recognized categories. The Cancer Genome Atlas Research Network has recently defined 4 new categories of endometrial cancer on the basis of mutational spectra, copy number alteration, and microsatellite instability, which might provide independent prognostic information beyond established risk factors...
April 2017: Archives of Pathology & Laboratory Medicine
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