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Related Experiment Video

Updated: Mar 29, 2026

Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
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Endometrial stromal sarcoma presenting as large bleeding left upper quadrant mass.

Gaya Spolverato1, Elizabeth Montgomery1, Ihab Kamel1

  • 11 Department of Surgery, 2 Department of Pathology, 3 Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Hepatobiliary Surgery and Nutrition
|November 26, 2015
PubMed
Summary

Endometrial stromal sarcoma (ESS), a rare uterine cancer, can present as a large abdominal mass. This case highlights the need for a multidisciplinary approach in managing symptomatic ESS.

Keywords:
Endometrial stromal sarcoma (ESS)left upper quadrant masssarcomasurgery

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Area of Science:

  • Gynecologic Oncology
  • Surgical Pathology
  • Abdominal Surgery

Background:

  • Endometrial stromal sarcoma (ESS) is a rare uterine malignancy, accounting for only 0.2% of all uterine cancers.
  • Symptomatic presentations of ESS are uncommon, making diagnosis and treatment challenging.
  • Intra-abdominal masses can represent atypical presentations of uterine malignancies.

Purpose of the Study:

  • To report a rare case of a young female presenting with a large, symptomatic abdominal mass due to endometrial stromal sarcoma.
  • To emphasize the atypical presentation of ESS as an intra-abdominal mass.
  • To highlight the importance of a multidisciplinary approach in managing complex ESS cases.

Main Methods:

  • Case report of a young female with a large bleeding abdominal mass.
  • Surgical intervention involving en bloc excision of the mass with extensive organ resection (partial pancreatectomy, splenectomy, transverse colectomy, left nephrectomy, left adrenalectomy, diaphragm resection).
  • Histopathological analysis of the resected mass to determine the final diagnosis.

Main Results:

  • The patient presented with a large, bleeding intra-abdominal mass.
  • Surgical pathology confirmed a malignant spindle and epithelial cell neoplasm with features of a variant of endometrial stromal sarcoma.
  • Extensive surgical resection was performed due to the large size and invasive nature of the tumor.

Conclusions:

  • Endometrial stromal sarcoma can manifest atypically as an intra-abdominal mass.
  • Aggressive surgical management may be required for symptomatic and advanced ESS.
  • A multidisciplinary treatment strategy is essential for optimal patient outcomes in managing ESS.