[Detection of endometrial stromal sarcoma using endometrial cytology. Apropos of a case]

The authors report a case of endometrial stromal sarcoma which was detected by endometrial cytology. The tumour originates either in the stroma of the endometrium or in foci of myometrial adenomyosis. It occurs most frequently in patients who are more than 60 years of age. It appears as an intra-uterine polypoid mass and causes bleeding and pelvic pain. Its incidence is difficult to establish. Endometrial cytology is highly suggestive of stromal sarcoma when smears harbour numerous atypical sarcomatous cells mixed with regular endometrial cells. Biopsies of the endometrium show decidua-like arrangements of malignant cells. Stromal sarcoma constitutes the homologous form of mesenchymal tumours of the uterus. The prognosis depends on whether local recurrences occur and on the sites of metastases in which the sarcomatous component seems to be latent with lesions that resemble adenocarcinomata . The five years salvage rate is approximately 26 to 28%. Treatment is surgical with or without irradiation.