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treatment of endometrial stromal sarcoma

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...
October 6, 2016: 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...
September 13, 2016: 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...
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
Munekage Yamaguchi, Chimeddulam Erdenebaatar, Fumitaka Saito, Takeshi Motohara, Yo Miyahara, Hironori Tashiro, Hidetaka Katabuchi
BACKGROUND: There has been no consensus on the indications for the treatment of advanced low-grade endometrial stromal sarcoma (LGESS), and the possible effects of hormonal treatment including progestins and aromatase inhibitors have been reported. The aim of this study was to investigate the efficacy of aromatase inhibitor therapy with letrozole for patients with residual or recurrent LGESS. METHODS: We retrospectively reviewed the clinical response of patients with advanced LGESS who had been treated with letrozole...
November 2015: International Journal of Gynecological Cancer
Osamu Maeda, Suzuko Moritani, Shu Ichihara, Takami Inoue, Yutaka Ishihara, Shinichi Yamamoto, Makoto Ito, Yoko Matsumura, Kumiko Sugiyama, Maiko Horio, Ikuyo Kondo
INTRODUCTION: Low-grade endometrial stromal sarcoma is very rare and difficult to diagnose in the early stage. A standard treatment has not been established. In this case report of a patient with long-term survival, we describe an effective treatment for advanced low-grade endometrial stromal sarcoma. CASE PRESENTATION: A 24-year-old Japanese woman who presented with prolonged menstruation was diagnosed with leiomyoma on the basis of a specimen resected transvaginally...
2015: Journal of Medical Case Reports
Juan Zhou, Hua Zheng, San-Gang Wu, Zhen-Yu He, Feng-Yan Li, Guo-Qiang Su, Jia-Yuan Sun
BACKGROUND: To assess the efficacy of different treatment modalities on the outcome of patients with low-grade endometrial stromal sarcoma (LG-ESS). METHODS: Patients with LG-ESS who received hysterectomy from March 1991 to December 2013 were retrospectively analyzed. The associations between clinicopathologic variables and disease free survival (DFS) were evaluated. RESULTS: One hundred and fourteen patients met the eligibility requirements...
November 2015: International Journal of Surgery
Grace Kim, Huyen Q Pham, Amin Ramzan, Esther Elishaev, Paulette Mhawech-Fauceglia
We are reporting 3 cases of the uterine corpus with collision of endometrioid adenocarcinoma (EAC) with endometrial stromal sarcoma (ESS). The patients' ages ranged from 36 to 59 years old. The major clinical presentation was abnormal uterine bleeding. Microscopically, all 3 cases presented with 2 separate components, EAC Grade 1 and ESS (one low grade and two high grades). The EAC component ranged from 10% to 70%, and the ESS component ranged from 30% to 70% of total tumor volume. The EAC component was stage 1A in two cases and stage II in one case...
August 2015: Gynecologic Oncology Reports
Andres A Roma, Denise A Barbuto, Siavash Azadmanesh Samimi, Simona Stolnicu, Isabel Alvarado-Cabrero, Jose Chanona-Vilchis, Irene Aguilera-Barrantes, Mariza de Peralta-Venturina, Anais Malpica, Joanne K L Rutgers, Elvio G Silva
Although metastases and high-mortality are frequent in high-grade endometrial sarcomas (HGSs), these findings are less commonly seen in low-grade endometrial stromal sarcomas (LGESSs), even in cases with lymphovascular invasion (LVI). We hypothesized that the "bulging plugs" of tumor characteristic of LVI in LGESS are fundamentally different from LVI seen in HGS. We reviewed 70 uterine sarcomas: 42 HGSs (high-grade endometrial stromal sarcomas, undifferentiated uterine sarcoma, and leiomyosarcoma) and 28 LGESSs...
November 2015: Human Pathology
Anthony N Karnezis, Yemin Wang, Pilar Ramos, William Pd Hendricks, Esther Oliva, Emanuela D'Angelo, Jaime Prat, Marisa R Nucci, Torsten O Nielsen, Christine Chow, Samuel Leung, Friedrich Kommoss, Stefan Kommoss, Annacarolina Silva, Brigitte M Ronnett, Joseph T Rabban, David D Bowtell, Bernard E Weissman, Jeffrey M Trent, C Blake Gilks, David G Huntsman
Small cell carcinoma of the ovary, hypercalcaemic type (SCCOHT) is a lethal and sometimes familial ovarian tumour of young women and children. We and others recently discovered that over 90% of SCCOHTs harbour inactivating mutations in the chromatin remodelling gene SMARCA4 with concomitant loss of its encoded protein SMARCA4 (BRG1), one of two mutually exclusive ATPases of the SWI/SNF chromatin remodelling complex. To determine the specificity of SMARCA4 loss for SCCOHT, we examined the expression of SMARCA4 by immunohistochemistry in more than 3000 primary gynaecological tumours...
February 2016: Journal of Pathology
Mehmet Metin Seker, Ali Ugur Uslu, Hatice Ozer, Ayse Seker, Turgut Kacan, Nalan Babacan, Handan Aker, Sahande Elagoz
Endocervical stromal sarcoma (ECSS) is a very rare uterine sarcoma. The most common presentation is pelvic mass and vaginal bleeding. The mainstay of treatment is surgery. There is no consensus on the adjuvant treatment. Relapses are usually in the pelvic and abdominal regions. To a lesser extent, lung, liver and bone metastases may be seen. A 46-year-old woman had total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) performed due to endometrial polyp and leiomyoma. Six months after the TAH-BSO, she was admitted to the hospital with cough and hemoptysis...
December 2014: Przeglad Menopauzalny, Menopause Review
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