Published online Jan 26, 2019. doi: 10.12998/wjcc.v7.i2.221
Peer-review started: October 13, 2018
First decision: November 15, 2018
Revised: December 9, 2018
Accepted: December 12, 2018
Article in press: December 12, 2018
Published online: January 26, 2019
Processing time: 107 Days and 1.1 Hours
Metastatic low-grade endometrial stromal sarcoma (LG-ESS) with sex cord-like and smooth muscle-like differentiation is rare. This article reports such a case with multiple recurrences and with extensive pelvic and abdominal metastasis.
A 47-year-old female patient was diagnosed with multiple cystic masses in the pelvic cavity by magnetic resonance imaging examination. Based on the postoperative pathological and immunohistochemical analyses of the surgical specimen, she was diagnosed with a metastatic low-grade endometrial stromal sarcoma with sex cord and smooth muscle differentiation.
LG-ESS is a low-grade malignant tumor with a high recurrence rate and metastasis probability. It is easily misdiagnosed initially. It is essential to distinguish LG-ESS with sex cord-like differentiation from uterine tumour resembling ovarian sex cord tumour.
Core tip: Endometrial stromal sarcomas are common tumours. Metastatic low-grade endometrial stromal sarcoma (LG-ESS) with sex cord and smooth muscle differentiation, however, is an extremely rare diagnosis. To date, only two cases have been reported in the literature. Histopathologic examination revealed a uterine leiomyoma within a pelvic mass. LG-ESS with sex cord-like differentiation should be distinguished from uterine tumor resembling ovarian sex cord tumor.