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A case of high-grade endometrial stromal sarcoma arising from endometriosis in the cul-de-sac
  1. M. Kusaka,
  2. M. Mikuni and
  3. M. Nishiya
  1. Department of Obstetrics and Gynecology, Sapporo Kosei General Hospital, Chuo-ku, Sapporo, Japan
  1. Address correspondence and reprint requests to: Masumi Kusaka, MD, Department of Obstetrics and Gynecology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 060-0033, Japan. Email: capris{at}par.odn.ne.jp

Abstract

This report describes a rare case of high-grade endometrial stromal sarcoma (ESS) arising from pathologically confirmed endometriosis in the cul-de-sac. A 37-year-old woman presented with irregular menstruation, pelvic pain, and diarrhea. Magnetic resonance imaging and colon biopsy suggested endometriotic nodule of the cul-de-sac. The tumor size was reduced with hormonal therapy, and the residual tumor was excised, resulting in the pathologic diagnosis of endometriosis. Two years later, a soft mass reappeared with rapid growth. Tumor extraction was performed, and the histopathologic diagnosis was high-grade ESS. Neither hormonal therapy nor chemotherapy was effective, and the patient died 6 months postoperatively. ESS should be included in the differential diagnosis of malignant transformation of endometriosis.

  • cul-de-sac
  • endometriosis
  • extrauterine
  • high-grade endometrial stromal sarcoma
  • malignant transformation

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