Introduction/Background Endometrial stromal sarcoma is a rare subgroup of uterin sarcomas. More than half the patients are premenopausal, young women and girls may be affected. Abnormal vaginal bleeding is the most common presenting symptom, and abdominal pain and uterine enlargement may occur. Total abdominal hysterectomy and bilateral salpingo-oophorectomy, with radical cytoreductive surgery for extrauterine involvement, has been the standard recommendation for endometrial stromal sarcomas. Preservation of the ovaries is contravertial. Adnexal metastases were indentified in 11 of 87 cases (%13) in the series from Memorial Sloan Kettering, and all were macroscopically apparent. This group has higher recurrence rates. It is concluded that ovarian preservation may be an option in well-informed patients. We presented a 24 years old women with low grade endometrial sarcoma.

Methodology In our case report, a 24 years old married women came with abnormal uterin bleeding. In Pelvic MR report, a large fibroid seen also suspected to sarcoma. The curettage result was reported as an uterin sarcoma. Patient is screened with PETCT and tumor is limited to the uterus. The patient well-informed about standard treatment and she did not accept salpingo-oophorectomy at the first line treatment. Total Abdominal Histerectomy operation made and final patological result reported as low grade endometrial sarcoma, tumor size 6,5 cm and more than half myometrial invasion.

Results The patient informed again about choices; salpingo-oophorectomy and preserving of ovaries with risks and outcomes. She selected the preserving ovaries option and being observed in often intervals.

Conclusion Low Grade Endometrial Sarcomas must be considered in young patients with abnormal uterine bleeding and including suspected fibroids. Although hysterectomy and salpingo-oophorectomy is the standard treatment, in young patients, fertility sparing approaches and preserving ovaries can be priority for their choice. We well inform them about these choices and observe in short intervals.

Disclosures endometrial stromal sarcoma, ovarian sparing, fertility sparing