Download PDF
CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2018; 37(01): 42-46
DOI: 10.1055/s-0037-1615257
Case Report | Relato de Caso
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Low-grade Endometrial Stromal Sarcoma with Unusual Metastasis to the Skull

Sarcoma endometrial estromal de baixo grau com metástase incomum no crânio
Antonio Santos de Araújo Júnior
1   Department of Neurosurgery, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
Pedro Alberto Arlant
1   Department of Neurosurgery, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
Arnaldo Salvestrini Júnior
1   Department of Neurosurgery, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
Angelo Fernandez
2   Department of Thoracic Surgery, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
Marcos Fernando de Lima Docema
3   Department of Neuroradiology, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
Rômulo Loss Mattedi
4   Department of Pathology, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
Thales Parenti Silveira
4   Department of Pathology, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
José Guilherme Mendes Pereira Caldas
5   Department of Interventional Neuroradiology, Hospital Sírio-libanês, São Paulo, SP, Brazil
,
Mirella Martins Fazzito
6   Department of Neurology, Hospital Sírio-libanês, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

21 July 2017

13 November 2017

Publication Date:
15 December 2017 (online)

Also available at
   Permissions and Reprints

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.

Keywords

endometrial stromal sarcoma - lung and skull metastases

Palavras-chave

sarcoma endometrial estromal - metástases pulmonar e craniana

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
    CrossrefPubMedGoogle Scholar
  • 2 Koga T, Ushijima K, Kage M. , et al. Pulmonary metastasis of endometrial stromal sarcoma. Kurume Med J 2006; 53 (3-4): 95-97
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 5 Nucci MR. Practical issues related to uterine pathology: endometrial stromal tumors. Mod Pathol 2016; 29 (Suppl. 01) S92-S103
    CrossrefPubMedGoogle Scholar
  • 6 Amant F, Coosemans A, Debiec-Rychter M, Timmerman D, Vergote I. Clinical management of uterine sarcomas. Lancet Oncol 2009; 10 (12) 1188-1198
    CrossrefPubMedGoogle Scholar
  • 7 D'Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol 2010; 116 (01) 131-139
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 13 Xue WC, Cheung AN. Endometrial stromal sarcoma of uterus. Best Pract Res Clin Obstet Gynaecol 2011; 25 (06) 719-732
    CrossrefPubMedGoogle Scholar
  • 14 Robert J. Kurman, Maria Luisa Carcangiu, C. Simon Herrington, Robert H. WHO Classification of Tumours of Female Reproductive Organs. Lyon: IARC; 2014
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar