RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0037-1615257
Low-grade Endometrial Stromal Sarcoma with Unusual Metastasis to the Skull
Sarcoma endometrial estromal de baixo grau com metástase incomum no crânioPublikationsverlauf
21. Juli 2017
13. November 2017
Publikationsdatum:
15. Dezember 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00028832/201801/lookinside/thumbnails/10-1055-s-0037-1615257_1700065-1.jpg)
Abstract
Background Endometrial stromal sarcomas (ESSs) are the second most common uterine sarcomas. Although ESSs are often indolent, they have metastatic potential. To the best of our knowledge, there are only three reports of brain metastasis, and the present report is the first to describe a late skull metastasis of an ESS.
Case Report We describe the case of a 51-year-old woman who presented abnormal vaginal bleeding 14 years ago; she was diagnosed with an uterine mass and submitted to a hysterectomy. One year ago she presented ESS lung metastasis followed by a left parietal calvarial metastasis. The optimal treatment for metastatic ESS is controversial, but the use of progesterone and aromatase inhibitors is advisable.
Resumo
Introdução Sarcoma endometrial estromal (SEE) é a segunda lesão mais frequente dentre os sarcomas uterinos. Geralmente são lesões indolentes, mas com potencial de desenvolver metástase. Até o momento há apenas três relatos de metástase cerebral, sendo este o primeiro estudo a descrever uma metástase craniana tardia dessas lesões.
Relato de caso Nós descrevemos o caso de uma paciente de 51 anos de idade que apresentou há 14 anos um quadro de sangramento vaginal anormal, sendo diagnosticada uma massa uterina; a paciente foi submetida a uma histerectomia. Há um ano ela evoluiu com metástase pulmonar, seguida por metástase craniana parietal esquerda. O tratamento ideal do SEE metastático ainda é controverso, mas o uso de inibidores de aromatase é aconselhável.
Informed Consent
The patient has consented to the submission of this case report to the journal.
-
References
- 1 Akhavan A, Shishebor F, Moghimi M, Binesh F. Endometrial stromal sarcoma of uterus with metastasis to the lung and brain. BMJ Case Rep 2012; 2012: 2012
- 2 Koga T, Ushijima K, Kage M. , et al. Pulmonary metastasis of endometrial stromal sarcoma. Kurume Med J 2006; 53 (3-4): 95-97
- 3 Behtash N, Akhavan S, Gilani MM, Mousavi A, Ghaemmaghami F, Mazhari MM. Low grade endometrial stromal sarcoma of uterine: review of 17 cases. Acta Med Iran 2011; 49 (09) 619-624
- 4 Richmond AM, Rohrer AJ, Davidson SA, Post MD. Low-grade endometrial stromal sarcoma with extensive sex cord differentiation, heterologous elements, and complex atypical hyperplasia: Case report and review of literature. Gynecol Oncol Rep 2016; 19: 34-38
- 5 Nucci MR. Practical issues related to uterine pathology: endometrial stromal tumors. Mod Pathol 2016; 29 (Suppl. 01) S92-S103
- 6 Amant F, Coosemans A, Debiec-Rychter M, Timmerman D, Vergote I. Clinical management of uterine sarcomas. Lancet Oncol 2009; 10 (12) 1188-1198
- 7 D'Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010; 116 (01) 131-139
- 8 Riopel J, Plante M, Renaud MC, Roy M, Têtu B. Lymph node metastases in low-grade endometrial stromal sarcoma. Gynecol Oncol 2005; 96 (02) 402-406
- 9 Shakerian B, Mandegar MH, Moradi B, Roshanali F. Heart and Lung Metastases From Endometrial Stromal Sarcoma in a Forty-Two-Year-Old Woman. Res Cardiovasc Med 2015; 4 (03) e26066
- 10 Seker MM, Uslu AU, Ozer H. , et al. Orbital metastasis of endocervical stromal sarcoma: a rare tumor and an uncommon metastasis. Przegl Menopauz 2014; 13 (06) 356-358
- 11 Chow LT. Delayed osseous metastasis from low-grade endometrial stromal sarcoma: Uncommon occurrence deserving recognition. J Obstet Gynaecol Res 2015; 41 (10) 1669-1675
- 12 Murakami A, Hayashi T, Terao Y. , et al. Cystic, nodular and cavitary metastases to the lungs in a patient with endometrial stromal sarcoma of the uterus. Intern Med 2014; 53 (09) 1001-1005
- 13 Xue WC, Cheung AN. Endometrial stromal sarcoma of uterus. Best Pract Res Clin Obstet Gynaecol 2011; 25 (06) 719-732
- 14 Robert J. Kurman, Maria Luisa Carcangiu, C. Simon Herrington, Robert H. WHO Classification of Tumours of Female Reproductive Organs. Lyon: IARC; 2014
- 15 Ramia JM, De la Plaza R, Garcia I, Perna C, Veguillas P, García-Parreño J. Liver metastasis of endometrial stromal sarcoma. World J Hepatol 2012; 4 (12) 415-418
- 16 Schick U, Bolukbasi Y, Thariat J. , et al. Outcome and prognostic factors in endometrial stromal tumors: a Rare Cancer Network study. Int J Radiat Oncol Biol Phys 2012; 82 (05) e757-e763
- 17 Haberal A, Kayikçioğlu F, Boran N, Calişkan E, Ozgül N, Köse MF. Endometrial stromal sarcoma of the uterus: analysis of 25 patients. Eur J Obstet Gynecol Reprod Biol 2003; 109 (02) 209-213
- 18 Shah JP, Bryant CS, Kumar S, Ali-Fehmi R, Malone Jr JM, Morris RT. Lymphadenectomy and ovarian preservation in low-grade endometrial stromal sarcoma. Obstet Gynecol 2008; 112 (05) 1102-1108
- 19 Nakayama K, Ishikawa M, Nagai Y, Yaegashi N, Aoki Y, Miyazaki K. Prolonged long-term survival of low-grade endometrial stromal sarcoma patients with lung metastasis following treatment with medroxyprogesterone acetate. Int J Clin Oncol 2010; 15 (02) 179-183
- 20 Pink D, Lindner T, Mrozek A. , et al. Harm or benefit of hormonal treatment in metastatic low-grade endometrial stromal sarcoma: single center experience with 10 cases and review of the literature. Gynecol Oncol 2006; 101 (03) 464-469
- 21 Ebina Y, Katabuchi H, Mikami M. , et al. Japan Society of Gynecologic Oncology guidelines 2013 for the treatment of uterine body neoplasms. Int J Clin Oncol 2016; 21 (03) 419-434