Endometrial stromal sarcomas

This study is a clinicopathologic evaluation of seven patients with endometrial stromal sarcoma of pure homologous type. Histologic distinction from endometrial stromatosis was based on the presence of high mitotic activity and nuclear anaplasia. One sarcoma appeared to have originated from invasive stromatosis. All patients died within 27 months although the tumor was judged to have been confined to the uterus at the time of hysterectomy in five patients. The aggressive clinical behavior and high mortality rate documented in this and other studies indicate that stromal sarcoma should be distinguished from the better differentiated and more indolent endometrial stromal tumor known as stromatosis or endolymphatic stromal myosis. It is suggested that surgery be supplemented by irradiation and/or chemotherapy as primary treatment for stromal sarcoma in view of its dismal prognosis.