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Primary ovarian high-grade endometrial stromal sarcoma: a case report
Ji Sun Lee1, Dayong Lee1, Jisun Lee1
1Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
Journal of Medical Case Reports
|August 3, 2021
Summary
Primary ovarian high-grade endometrial stromal sarcoma is rare with poor prognosis. Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy offers a potential therapeutic option for advanced cases with peritoneal dissemination.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Medical Oncology
Background:
- Primary ovarian high-grade endometrial stromal sarcoma (HG-ESS) is an exceptionally rare malignancy.
- Established gold-standard treatment protocols are lacking due to the disease's rarity and associated poor prognosis.
Observation:
- A 49-year-old woman presented with disseminated intravascular coagulation secondary to a ruptured primary HG-ESS with extensive intraperitoneal metastases.
- Initial management included debulking surgery and adjuvant Adriamycin chemotherapy.
- A secondary cytoreductive operation with hyperthermic intraperitoneal chemotherapy (paclitaxel) was performed.
Findings:
- The patient remains alive for 28 months following the combined surgical and chemotherapeutic intervention.
- This case demonstrates the feasibility and potential efficacy of aggressive surgical management coupled with HIPEC.
Implications:
- Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) may represent a viable therapeutic strategy for patients with primary ovarian HG-ESS and peritoneal dissemination.
- Further research into multimodal treatment approaches is warranted for this rare and aggressive gynecologic cancer.
