Introduction/Background Low grade endometrial stromal sarcoma are a group of indolent tumors with good prognosis. It usually occur in women of 40 to 50 years with a five year survival of approximately 90%. Primary comprehensive surgical management is an independent factor affecting disease free survival and overall survival.

Methodology We are presenting a series of 4 cases of endometrial stromal sarcoma with diverse pattern of prognosis.

Results Low grade ESS is usually with good prognosis with long DFS.One patient was presented with immediate post-operative extensive recurrrenc as a result of laparoscopic morcellation. In the second case patient had seven years disease free interval. Then she developed a single site recurrence which was resectable with good prognosis. The third case in the series patient was put on primary hormonal treatment for twenty months as she was not willing for hysterectomy.Later hysterectomy was performed and still patient has got good prognosis with seven years of disease free interval.Fourth case underwent hysterectomy with bilateral salpingoophorectomy and kept under follow up.She alsohas a fairly good disease free interval of 8 years following primary surgery without intraoperative spillage.

Conclusion Preoperative diagnosis of endometrial sarcoma may not be possible. Hence it is better to avoid open morcellation during laparoscopic myomectomy. Many Gynaecologists are using contained morcellators for tissue extraction. More data is needed regarding safety of the new devices

Disclosure Nothing to disclose.