Treatment of stage IV "high-grade" endometrial stromal sarcoma with ifosfamide, adriamycin, and cisplatin

A 46-year-old woman with stage IV "high-grade" endometrial stromal sarcoma presented with massive uterine bleeding and dyspnea. Her WHO performance status was grade 4. After chemotherapy consisting of ifosfamide, Adriamycin, and cisplatin, the uterus shrank from 20 x 15 x 15 to 6 x 6 x 8 cm and multiple pulmonary nodules almost completely disappeared. The PO2 increased from 57.8 to 89.3 mmHg and her performance status improved to grade 0, making it possible for pelvic surgery to be performed. At 10 months postoperatively, there was no evidence of disease. This case suggests that IAP might be effective chemotherapy for patients with high-grade endometrial stromal sarcoma.