Endometrial stromal sarcoma invading the abdominal aorta treated with aortic replacement

Endometrial stromal sarcomas are extremely rare tumors with few reports describing invasion of major blood vessels. Tumors that primarily involve the abdominal aorta or invade the vessel secondarily are uncommon. Outcomes from radical tumor resection and aortic reconstruction are thus poorly understood. We present a rare case of a symptomatic recurrent endometrial stromal sarcoma with encasement of the infrarenal abdominal aorta requiring en bloc tumor resection and in situ aortic replacement.