Introduction/Background Endometrial stromal tumors (EST) represent less than 1% of all uterine malignant neoplasms. Those include endometrial stromal nodule (ESN), low-grade stromal sarcoma (LGESS), high-grade stromal sarcoma (HGESS), undifferentiated uterine sarcoma (UUS), uterine adenosarcoma (ADENOSA) and uterine tumor resembling ovarian sex cord tumor (UTROSCT). Treatment typically includes a combination of surgery and chemotherapy. Radiotherapy may be also used for local control. Herein we present a case series of 14 patients.
Methodology We found a total of 14 patients (median age 60.4). 7 patients had stage I disease, 2 stage II, 1 stage III and 5 stage IV. Early stage patients were mostly managed with surgery with/without adjuvant endocrine therapy and chemotherapy. Advanced disease patients received endocrine therapy and/or chemotherapy.
Results 2 ADENOSA patients are still in remission 3 years after surgery alone and 2 UTROSCT patients are in remission 1 and 3 years after surgery alone. 1 stage I UUS patient is free of disease 5 years after surgery and adjuvant chemotherapy. 1 patient with stage I LGESS, 1 patient with stage II LGESS and 1 patient with stage IV LGESS were lost to the follow up. 1 patient with LGESS stage I experienced distant relapse 3 months postoperatively and has been receiving multiple regimens of chemotherapy for 3 years eversince, with rapidly progressive disease nonetheless. 1 patient with stage II LGESS experienced pelvic recurrence 2 months post surgery, she was managed with chemoradiation and has developed upper abdominal disease 3 years postoperatively. 2 patients with extensive metastatic disease stage IVb were referred to palliative care. 2 patients with stage IVb LGESS and HGESS were managed with endocrine therapy and chemotherapy; however, they died at the one year mark.
Conclusion Endometrial stromal tumors are rare neoplasms; a combination of surgical cytoreduction, endocrine therapy and chemotherapy is the standard treatment approach.
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