Endometrial stromal sarcoma invading the abdominal aorta treated with aortic replacement

Area of Science:

• Oncology
• Vascular Surgery
• Gynecologic Oncology

Background:

• Endometrial stromal sarcoma (ESS) is a rare uterine malignancy.
• Vascular invasion by ESS, particularly of the abdominal aorta, is exceptionally uncommon.
• Surgical management and outcomes for ESS involving major blood vessels remain poorly defined.

Observation:

• A patient presented with a symptomatic, recurrent endometrial stromal sarcoma.
• The tumor encasing the infrarenal abdominal aorta required complex surgical intervention.
• En bloc tumor resection combined with in situ aortic replacement was performed.

Findings:

• This case demonstrates the feasibility of radical resection for advanced ESS with aortic involvement.
• Successful in situ aortic replacement was achieved, preserving aortic continuity.
• The surgical approach addressed both tumor extirpation and vascular reconstruction.

Implications:

• This case contributes to understanding the surgical management of rare ESS with vascular invasion.
• It highlights a potential strategy for managing similar complex oncologic and vascular emergencies.
• Further research is warranted to establish optimal treatment protocols for ESS involving major arteries.