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The diagnostic problem of endometrial stromal sarcoma: report on six cases
Frédéric Amant1, Philippe Moerman, Isabelle Cadron
1Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven 3000, Belgium. Frederic.Amant@uz.kuleuven.ac.be
Objective:
The objective was to look for the incidence and clinicopathologic findings of women in whom the diagnosis of endometrial stromal sarcoma was initially missed.
Methods:
We carried out a retrospective analysis of cases treated at our institution from 1990 to 2002.
Results:
In 6/15 (40%) women suffering from endometrial stromal sarcoma, the diagnosis initially was missed. The first diagnosis was uterine leiomyoma (n = 2), myxoid leiomyoma (n = 2), cellular leiomyoma (n = 1), or lymphatic disorder (n = 1). The final diagnosis was only made after consultation of a pathologist with a special interest in gynecological oncology. The mean age of this group was only 34 years (range, 18-53). A mean delay in diagnosis of 143 months (range, 24-408) resulted in stage 4 disease in 5/6 women. After a mean follow-up of 16 years (range, 5-43), 4/6 are without macroscopic evidence of disease, 1/6 with evidence of disease, and 1/6 died of disease.
Conclusion:
Especially in younger women, the diagnosis of endometrial stromal sarcoma can be problematic.