Retrospective analysis of 12 cases of low grade extrauterine endometrial stromal sarcoma and literature review

doi:10.19401/j.cnki.1007-3639.2024.04.009

Abstract

CLC Number:

R737.33

SHI Jialu, ZHU Tingting, TAO Xiang, MA Fenghua, LIN Zhi, SHAO Jun, ZHAO Yuqing. Retrospective analysis of 12 cases of low grade extrauterine endometrial stromal sarcoma and literature review[J]. China Oncology, 2024, 34(4): 418-424.

Figures/Tables 3

Tab. 1

Baseline clinical characteristics of 12 patients with LGEESS"

No	Age	Menstruation status	Gravidity	Parity		Dysmenorrhea		Endometriosis	Uterine myoma-related surgery		Initial clinical presentation
1	51	Postmenopausal	3	3		-		+	-		Abdominal pain
2	44	Premenopausal	5	2		-		-	-		Abdominal swelling and pain
3	27	Premenopausal	0	0		+		+	-		-
4	33	Premenopausal	2	1		+		-	-		Urinary retention
5	40	Premenopausal	4	1		+		-	Myomectomy		-
6	50	Postmenopausal	1	1		-		+	Myomectomy + STH		-
7	34	Premenopausal	3	1		-		-	Myomectomy		-
8	50	Premenopausal	3	1		-		+	Myomectomy		Abdominal pain
9	59	Postmenopausal	2	1		+		+	-		Abdominal swelling and pain
10	73	Postmenopausal	2	1		-		+	-		Frequent micturition, abdominal swelling
11	47	Postmenopausal	2	1		-		+	-		Abdominal pain
12	50	Postmenopausal	2	2		+		+	-		Oppression in chest and anhelation
No	Location				Size D/cm		Treatment		PFS t/month	Location of recurrence		Follow-up t/month
1	Bilateral ovary				6		TH + BSO + CT		Unk	Unk		Unk
2	Left ovary, omentum, colon				5.5		TH + BSO + tumor resection + CT		-	-		NED (148)
3	Uterosacral ligament, posterior lobe of broad ligament				4		FSS + HT1		12	Pelvis		NED (97)
4	Retroperitoneum				12		Tumor resection + TH + BSO + ureteroscope + cystoscope + ureteral stenting		-	-		NED (95)
5	Bilateral ovaries, peritoneum, mesentery, intestine				4		Tumor resection + TH + BSO + L + RT + HT2		-	-		NED (74)
6	Left ovary				6		Cervicectomy + BSO + L + omentectomy + CT		-	-		NED (67)
7	Retroperitoneum				6		FSS + HT3		33	Peritoneum		NED (49)
8	Omentum, pelvic				7		Tumor resection + TH + BSO + omentectomy + HT3		8	Abdominopelvic, abdominal wall, ascending colon, duodenum, liver		AWD (40)
9	Bilateral ovaries				11		TH + BSO + HT3		-	-		NED (34)
10	Right ovary, spread to left ovary and uterus				15		TH + BSO + L + HT3		-	-		NED (8)
11	Left ovary, spread to the serous surface of both fallopian tubes and uterus				7		TH + BS + tumor resection + ureteral stenting		15	Bilateral ovaries, peritoneum, omentum, roof of vagina, rectum		NED (25)
12	Abdominopelvic, chest or liver				-		FNA		0	-		DOD (6)

Tab. 1

Tab. 2

Tab. 3

References 20

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Parameter	Number of patients	Percentage/%	Parameter	Number of patients	Percentage/%
Tumor primary location			Presence of sex cord differentiation	2	16.7
Ovary	7	58.3	Presence of glandular differentiation	1	8.3
Others	5	41.7	Associated endometriosis
Tumor amount			+	7	58.3
1	3	25.0	-	5	41.7
≥2	9	75.0	Immunohistochemical results
Maximum tumor diameter D/cm			ER+	10	83.3
≤5	2	16.7	PR+	10	83.3
>5	10	83.3	CD10+	12	100.0
LVSI			FISH
+	0	0	JAZF1⁺	3	25.0
-	12	100.0	JAZF1^-	2	16.7
Morphologic patterns			YWHAE^-	1	8.3
Presence of smooth muscle differentiation	2	16.7	BCOR^-	2	16.7

Characteristic	Case n	Percentage/%	Characteristic	Case n	Percentage/%
Age/year			Associated endometriosis
≤50	67	60.4	+	35	-
>50	44	39.6	-	5	-
Initial clinical presentation	85		Immunohistochemical results
Abdominal pain or swelling	37	43.5	ER⁺	61	87.1
Vaginal bleeding	10	11.8	PR⁺	62	88.6
None	26	30.6	CD10⁺	66	93.0
CA12-5			FISH
Elevated	16	-	JAZF1⁺	4	-
Normal	5	-	JAZF1^-	1	-
Tumor primary location			YWHAE^-	1	-
Ovary	66	59.5	BCOR^-	0	-
Others	45	40.5	Initial surgery	110
Tumor amount			TH+BSO	57	51.8
1	55	58.5	Tumor section	18	16.4
≥2	39	41.5	Lateral adnexectomy	10	9.1
Maximum tumor diameter D/cm			Lymphadenectomy	6	5.5
≤5	25	27.5	HT	28	-
>5	66	72.5

Retrospective analysis of 12 cases of low grade extrauterine endometrial stromal sarcoma and literature review

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[2]	HE Qingfeng, WU juan, ZHANG Jingyu, et al. Intermittent hormonal therapy for patients with advanced prostate cancer [J]. China Oncology, 2015, 25(12): 989-993.