Extra-uterine endometrial stromal sarcoma arising from deep infiltrating endometriosis.

Autor: Lipsich F; Radiology Service, Hospital Italiano de Buenos Aires, Argentina. Electronic address: Federico.lipsich@hospitalitaliano.org.ar., Causa Andrieu PI; Radiology Service, Hospital Italiano de Buenos Aires, Argentina; Radiology Department, Memorial Sloan Ketterring Cancer Center, United States. Electronic address: causapamela@gmail.com., Wernicke A; Pathology Service, Hospital Italiano de Buenos Aires, Argentina. Electronic address: Alejandra.wernicke@hospitalitaliano.org.ar., Patrono MG; Gynecology Service, Hospital Italiano de Buenos Aires, Argentina. Electronic address: Maria.patrono@hospitalitaliano.org.ar., Napoli MN; Radiology Service, Hospital Italiano de Buenos Aires, Argentina. Electronic address: Maria.napoli@hospitalitaliano.org.ar., Chacon CRB; Radiology Service, Hospital Italiano de Buenos Aires, Argentina. Electronic address: Carolina.chacon@hospitalitaliano.org.ar., Nicola R; Roswell Park Comprehensive Cancer Center, United States.
Jazyk: angličtina
Zdroj: Clinical imaging [Clin Imaging] 2020 Nov; Vol. 67, pp. 250-254. Date of Electronic Publication: 2020 Aug 26.
DOI: 10.1016/j.clinimag.2020.08.015
Abstrakt: We present a compelling case of a 45-year-old female with a history of endometriosis and leiomyomas, who presented to her gynecologist with chronic pelvic pain complaints. Both a transvaginal ultrasound (US) and an MRI (magnetic resonance imaging) were ordered. The US demonstrated multiple uterine lesions, likely fibroids, and an endometrioma within the right ovary. The MRI of the pelvis with and without gadolinium identified a mass within the right ovary with homogenous intermediate T2-signal, restricted diffusion, and delayed enhancement relative to the myometrium. Several irregular-shaped lesions were also noted within the external myometrium, anterior pelvic wall, and the peritoneum, which were intermediate signal on T2-weighted images, restricted diffusion, and an enhancement pattern similar to the myometrium. The patient underwent a right adnexectomy. The histopathology findings were consistent with a low-grade endometrial stromal sarcoma (low grade-ESS) arising from the endometrial stroma of the right ovary. A debulking surgery confirmed the involvement of external myometrium, anterior pelvic wall, and the peritoneum secondary to a low-grade ESS without the endometrial cavity's involvement. The underlying hypothesis is that the endometriosis stroma from extra-uterine structures such as the right ovary, pelvic and anterior peritoneum, and external myometrium may have subsequently resulted in a low-grade ESS. Low-grade extra-uterine ESS without endometrial involvement is a rare entity. Based on our literature search, this is one of the few reports covering the radiological features of low-grade extra-uterine ESS arising outside the uterus with a concomitant deep infiltrating endometriosis, but without the involvement of the endometrial cavity.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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