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Volume : 37 Issue : 2 Year : 2022



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Advanced-stage Endometrial Stromal Sarcoma Presenting as Primary Infertility in a Young Nulligravida: A Case Report [Medeniyet Med J]
Medeniyet Med J. 2022; 37(3): 293-297 | DOI: 10.4274/MMJ.galenos.2022.16132  

Advanced-stage Endometrial Stromal Sarcoma Presenting as Primary Infertility in a Young Nulligravida: A Case Report

Ankita PATTANAIK1, Jasmina BEGUM1, Sweta SINGH1, Deepthy BALAKRISHNAN1, Suvradeep MITRA2
1All India Institute of Medical Sciences, Department of Obstetrics and Gynecology, Bhubaneswar, India
2All India Institute of Medical Sciences, Department of Pathology, Bhubaneswar, India

Endometrial stromal sarcoma (ESS) rarely causes infertility in young women. We report a nulligravida in her 30s who presented with primary infertility of 15 years. Hysteroscopy revealed a submucosal necrotic fibroid polyp. Ultrasonography detected multiple intramural fibroids. Open myomectomy with polypectomy was performed. Histopathology revealed low-grade ESS (LGESS) within the fibroid polyp. Subsequently, the patient underwent completion surgery. Her final diagnosis was estrogen-receptor positive LGESS stage IIIB, and she was suggested anastrozole adjuvant therapy and long-term surveillance. ESS with abnormal perimenopausal bleeding, though the most common presentation, may not always observed. Hence, a high index of suspicion of ESS should always be kept as a differential diagnosis in uterine fibroid polyp, though rare. Considering the scarcity of more extensive studies on ESS, reporting of cases will aid in formulating management protocols.

Keywords: Uterine sarcoma, endometrial stromal sarcoma, low-grade endometrial stromal sarcoma, bilateral salpingo-oophorectomy, adjuvant radiation hormonal therapy


Genç Bir Nulligravida`da Primer İnfertilite Olarak Ortaya Çıkan İleri Evre Endometriyal Stromal Sarkom: Bir Olgu Sunumu

Ankita PATTANAIK1, Jasmina BEGUM1, Sweta SINGH1, Deepthy BALAKRISHNAN1, Suvradeep MITRA2
1All India Institute of Medical Sciences, Department of Obstetrics and Gynecology, Bhubaneswar, India
2All India Institute of Medical Sciences, Department of Pathology, Bhubaneswar, India

Endometriyal stromal sarkom (ESS) genç kadınlarda nadiren infertiliteye neden olmaktadır. Çalışmamızda 15 yıllık primer infertilite ile başvuran 30’lu yaşlarında bir nulligravida sunmaktayız. Histeroskopisinde submukozal nekrotik fibroid polip saptandı. Ultrasonografi birden fazla intramural fibroid olduğunu ortaya koydu. Polipektomi ile açık myomektomi yapıldı. Histopatoloji, fibroid polip içinde düşük dereceli ESS (LGESS) ortaya çıkardı. Ardından hastaya tamamlayıcı cerrahi uygulandı. Nihai tanısı östrojen reseptörü pozitif LGESS evre IIIB idi ve hastaya anastrozol adjuvan tedavisi ve uzun süreli gözetim önerildi. Anormal perimenopozal kanamalı ESS, en yaygın semptom olmasına rağmen her zaman gözlenmeyebilir. Bu nedenle, nadir de olsa uterin fibroid polipinde ESS şüphesi yüksek bir ayırıcı tanı olarak daima akılda tutulmalıdır. ESS ile ilgili daha kapsamlı çalışmaların azlığı göz önüne alındığında, olguların raporlanması yönetim protokollerinin formüle edilmesine yardımcı olacaktır.

Anahtar Kelimeler: Uterin sarkom, endometriyal stromal sarkom, düşük dereceli endometriyal stromal sarkom, bilateral salpingo-ooferektomi, adjuvan radyasyon hormonal tedavisi


Ankita PATTANAIK, Jasmina BEGUM, Sweta SINGH, Deepthy BALAKRISHNAN, Suvradeep MITRA. Advanced-stage Endometrial Stromal Sarcoma Presenting as Primary Infertility in a Young Nulligravida: A Case Report. Medeniyet Med J. 2022; 37(3): 293-297

Corresponding Author: Jasmina BEGUM, India


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