RT Journal Article
SR Electronic
T1 Severe Abdominal Recurrence of Low-grade Endometrial Stromal Sarcoma After Hysteroscopic Surgery
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 4013
OP 4016
DO 10.21873/anticanres.15199
VO 41
IS 8
A1 DAISUKE TAMURA
A1 DAICHI MAEDA
A1 KATSUHIKO ENOMOTO
A1 HIROKAZU SATO
YR 2021
UL http://ar.iiarjournals.org/content/41/8/4013.abstract
AB Background: Low-grade endometrial stromal sarcoma (LG-ESS) is an indolent tumor harboring gene fusion involving polycomb family genes. While early LG-ESS has a good clinical course, some tumors have pelvic recurrence. The etiology and genetic alterations involved in the process remain unknown. Case Report: A 44-year-old nulliparous woman underwent hysteroscopic surgery for a 2.5 cm submucosal uterine tumor with negative endometrial cytology. Pathological evaluation revealed LG-ESS. On the 31st day, total laparoscopic hysterectomy was indicated. She was diagnosed with stage IA (pT1aNXM0) LG-ESS without lymphovascular invasion. At 4 years, positron-emission tomography showed multiple pelvic masses. Secondary debulking surgery was performed, which revealed severe intra-abdominal recurrence of LG-ESS with JAZF1–SUZ12 fusion. Conclusion: Hysteroscopic surgery is a convenient tool for benign uterine submucosal diseases. However, intrauterine morcellation with fluid can lead to unexpected recurrence of occult LG-ESS. It is important when seeking consent for surgery to inform patients about the possible risk of dissemination of uterine mesenchymal tumors.