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Endometrial stromal sarcoma involving the placenta
W A Katsanis1, D M O'Connor, R K Gibb
1Division of Gynecologic Oncology, Kosair Children's Hospital, Louisville, KY, USA.
Annals of Diagnostic Pathology
|December 10, 1998
Summary
This report details two cases of low-grade endometrial stromal sarcoma found in the decidua during placental examination. These findings highlight the importance of evaluating placental tissue for rare gynecologic tumors.
Area of Science:
- Gynecologic Pathology
- Obstetrics
- Oncology
Background:
- Endometrial stromal sarcoma is a rare malignant tumor originating from the endometrial stroma.
- Diagnosis typically occurs in reproductive-aged women, often presenting with abnormal uterine bleeding.
- Placental examination is standard postpartum procedure, but rarely includes evaluation for gynecologic malignancies.
Observation:
- Two cases are presented where low-grade endometrial stromal sarcoma was identified in the decidua submitted with placentas.
- In the first case, the tumor was found in the omentum and decidua during a cesarean section for placenta previa.
- In the second case, a mass beneath the placenta, consistent with low-grade endometrial stromal sarcoma, was noted during a cesarean section for breech presentation.
Findings:
- These represent the first reported instances of endometrial stromal sarcoma involving the decidua.
- Histological examination confirmed the presence of low-grade endometrial stromal sarcoma in both cases.
- The tumors were detected incidentally during routine pathologic evaluation of placentas.
Implications:
- These findings suggest that endometrial stromal tumors can manifest within the decidua.
- Increased awareness among pathologists and obstetricians is warranted regarding the potential for detecting these rare tumors during placental examination.
- Routine placental pathology may serve as an unexpected diagnostic opportunity for certain gynecologic malignancies.