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Endometrial stromal tumors: Diagnostic updates and challenges
1Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas 75390 USA; Department of Pathology, Parkland Health and Hospital System, Dallas, TX, USA.
Seminars in Diagnostic Pathology
|January 24, 2022
Summary
This review clarifies the diagnosis of rare endometrial stromal tumors, including subtypes like endometrial stromal sarcoma. Accurate identification is crucial for effective patient management and treatment strategies.
Area of Science:
- Gynecologic Pathology
- Uterine Neoplasms
- Tumor Morphology
Background:
- Endometrial stromal tumors are rare uterine mesenchymal neoplasms originating from the endometrium.
- The 2020 WHO classification categorizes these tumors into endometrial stromal nodule, low-grade endometrial stromal sarcoma, high-grade endometrial stromal sarcoma, and undifferentiated uterine sarcoma.
- Accurate diagnosis is essential for appropriate patient management.
Purpose of the Study:
- To review and summarize the morphology, immunohistochemical profile, and molecular features of endometrial stromal tumors.
- To highlight key differential diagnoses and their distinguishing characteristics.
- To emphasize recent advancements and their practical application in diagnosing these challenging lesions.
Main Methods:
- Review of tumor morphology across different endometrial stromal tumor subtypes.
- Analysis of immunohistochemical phenotypes for diagnostic differentiation.
- Integration of molecular features to aid in diagnosis.
- Comparison with morphologic mimics of endometrial stromal lesions.
Main Results:
- Endometrial stromal tumors exhibit diverse morphological features.
- Immunohistochemistry and molecular markers are critical for distinguishing between subtypes and mimics.
- Overlapping features often necessitate a multi-modal diagnostic approach.
Conclusions:
- Accurate diagnosis of endometrial stromal tumors is challenging due to rarity and overlapping features.
- A comprehensive approach integrating morphology, immunohistochemistry, and molecular data is vital.
- This review provides updated insights for improved diagnostic accuracy in daily practice.
