Endometrioid stromal sarcomas of the ovary. A clinicopathologic analysis of 23 cases

The clinical and pathologic features of 23 endometrioid stromal sarcomas of the ovary were analyzed. The patients' ages ranged from 20 to 76 years (average, 54 years). The most common presenting symptom was abdominal swelling or pain. In 12 cases the tumors were unilateral and in 11 cases they involved both ovaries. Four of the tumors were Stage I, nine Stage II, and eight Stage III; two were Stage IV because of the presence of pulmonary metastases. In nine of the cases there was a prior, synchronous or subsequent endometrial stromal sarcoma of the uterus. Nineteen tumors with less than 10 mitotic figures (MF) per 10 high power fields (HPF) were classified as low grade and the remaining four tumors with 12 to 30 MF per 10 HPF were designated as high grade. Only 2 of the 19 patients with low-grade tumors are known to have died of their disease and 9 of those whose tumor had spread beyond the ovary at the time of presentation were alive one or more years postoperatively. Three of the four patients with high-grade tumors died of their disease within 4 years.