Locally Advanced Primary Cervical Endometrial Stromal Sarcoma: A Case Report

Primary cervical endometrial stromal sarcoma (ESS) is a challenging mesenchymal neoplasm that may present with non-specific clinical manifestations and advanced local disease at diagnosis. We report the case of a 50-year-old diabetic woman presenting with metrorrhagia and pelvic pain. Clinical examination revealed a large ulcerative cervical mass infiltrating the vaginal walls. Histopathology with immunohistochemistry supported the diagnosis of ESS. Imaging demonstrated extensive loco-regional invasion of the bladder, lower vagina, and rectal wall, consistent with FIGO stage IVA disease. The patient was treated with systemic chemotherapy (carboplatin-paclitaxel). This case highlights the diagnostic challenges of cervical ESS, the importance of histopathological and immunohistochemical evaluation, and the therapeutic considerations in locally advanced disease.