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Metastatic low-grade endometrial stromal sarcoma of clitoris: report of a case
  1. A. Androulaki,
  2. T. G. Papathomas,
  3. P. Alexandrou and
  4. A. C. Lazaris
  1. Department of Pathology, “Laiko” General Hospital of Athens, Athens, Greece
  1. Address correspondence and reprint requests to: Thomas G. Papathomas, MD, 12 Kerkiras Str., Kalamaria, GR-55133 Thessaloniki, Greece. Email: thomaspapathomas{at}


Low-grade endometrial stromal sarcoma (ESS) is an uncommon neoplasm, which has a highly recurrent nature. A review of the literature revealed that only one case of low-grade ESS, arising within the vulva from a focus of endometriosis, has been previously published. We describe an additional case of low-grade ESS arising within the vulva and to the best of our knowledge the first report of low-grade ESS metastasized to clitoris. A 46-year-old woman was admitted to our hospital due to a heavy uterine bleeding. A physical examination revealed a lesion in clitoris, which exhibited a densely cellular mesenchymal neoplasm on microscopy. On the basis of the pathologic features alone, a differential diagnosis of a low-grade ESS and cellular leiomyoma was considered. Seven months later, the patient presented again with excessive uterine bleeding and a total hysterectomy was performed. A tumor of white-tan, whorled appearance was found. Its features were suggestive of low-grade ESS. Taking into account the possible extrauterine location of an ESS and reviewing the first case, a diagnosis of rare low-grade ESS metastasized to clitoris was made

  • clitoris
  • low-grade endometrial stromal sarcoma
  • metastasis

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