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Delayed osseous metastasis from low-grade endometrial stromal sarcoma: Uncommon occurrence deserving recognition
1Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Shatin, Hong Kong.
The Journal of Obstetrics and Gynaecology Research
|July 15, 2015
Summary
Late recurrence of low-grade endometrial stromal sarcoma (ESS) can manifest as rare bone metastases, particularly in the spine. These spinal metastases present significant challenges, leading to poor prognosis and severe patient morbidity.
Area of Science:
- Oncology
- Pathology
Background:
- Low-grade endometrial stromal sarcoma (ESS) typically has an excellent prognosis but is known for late recurrences, even after early-stage disease.
- Bone metastases from ESS are rare, with only six cases previously reported in medical literature.
Observation:
- Two stage I ESS patients developed spinal metastases 9 and 15 years after primary tumor resection, presenting with back pain and neurological deficits.
- Imaging revealed vertebral tumors with spinal cord compression, confirmed as metastatic ESS by biopsy.
Findings:
- Despite treatment including surgery, radiotherapy, and chemotherapy, both patients experienced neurological symptom recurrence within 12 months.
- One patient died 44 months after recurrence due to widespread metastasis, while the other became paraplegic and wheelchair-bound.
Implications:
- Delayed osseous metastasis of low-grade ESS, especially to the spine, is uncommon but associated with a grave prognosis.
- The spinal location poses challenges for complete surgical resection, contributing to significant morbidity and mortality in affected patients.
