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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

A Rare Case of Extrauterine Endometrial Stromal Sarcoma Arising from Deep Pelvic Endometriosis: Role of Multidisciplinary Team Meeting

Author(s): Xueying Long, Yigang Pei, Ismail Bilal Masokano, Xin Zhu, Wei Lin, Siting He and Hui Liu*

Volume 19, Issue 4, 2023

Published on: 27 August, 2022

Article ID: e150622206052 Pages: 7

DOI: 10.2174/1573405618666220615161300

Price: $65

Abstract

Introduction: Extrauterine endometrial stromal sarcoma (EESS) arising from Deep pelvic endometriosis (DPE) has a poor life quality and is difficult to diagnose pre-operatively. However, the patient’s quality of life can be improved when it is diagnosed precisely and managed successfully.

Case Report: A 35-year-old woman presented to our hospital with a 3-month history of hematochezia and anal pain. Initially, she was misdiagnosed as a rectal stromal tumor and then precisely diagnosed as having EESS from DPE following several multidisciplinary team (MDT) meetings. The lesion was shrunk by gonadotrophin-releasing hormone agonist (GnRH-α) treatment and then resected with minimal trauma.

Conclusion: MDT is crucial in the treatment of the patient. It can promote individualized treatment and improve patient’s quality of life.

Keywords: MDT, EESS arising from DPE, MRI, Diagnosis, Treatment, computed tomography

Graphical Abstract

[1]
Ait Benkaddour, Y.; El Farji, A.; Soummani, A. Endometriosis of the vesico-vaginal septum: A rare and unusual localization (case report). BMC Womens Health, 2020, 20(1), 179.
[http://dx.doi.org/10.1186/s12905-020-01047-w] [PMID: 32795369]
[2]
Coutinho, A., Jr; Bittencourt, L.K.; Pires, C.E.; Junqueira, F.; Lima, C.M.; Coutinho, E.; Domingues, M.A.; Domingues, R.C.; Marchiori, E. MR imaging in deep pelvic endometriosis: A pictorial essay. Radiographics, 2011, 31(2), 549-567.
[http://dx.doi.org/10.1148/rg.312105144] [PMID: 21415196]
[3]
Ali, R.H.; Rouzbahman, M. Endometrial stromal tumours revisited: An update based on the 2014 WHO classification. J. Clin. Pathol., 2015, 68(5), 325-332.
[http://dx.doi.org/10.1136/jclinpath-2014-202829] [PMID: 25595274]
[4]
Lipsich, F.; Causa Andrieu, P.I.; Wernicke, A.; Patrono, M.G.; Napoli, M.N.; Chacon, C.R.B.; Nicola, R. Extra-uterine endometrial stromal sarcoma arising from deep infiltrating endometriosis. Clin. Imaging, 2020, 67, 250-254.
[http://dx.doi.org/10.1016/j.clinimag.2020.08.015] [PMID: 32890909]
[5]
Baiocchi, G.; Kavanagh, J.J.; Wharton, J.T. Endometrioid stromal sarcomas arising from ovarian and extraovarian endometriosis: Report of two cases and review of the literature. Gynecol. Oncol., 1990, 36(1), 147-151.
[http://dx.doi.org/10.1016/0090-8258(90)90126-6] [PMID: 2403959]
[6]
Burke, C.; Hickey, K. Treatment of endometrial stromal sarcoma with a gonadotropin-releasing hormone analogue. Obstet. Gynecol., 2004, 104(5 Pt 2), 1182-1184.
[http://dx.doi.org/10.1097/01.AOG.0000133533.05148.aa] [PMID: 15516445]
[7]
Carbone, F.; Kaur, M.M.; Chok, A.Y.; Kontovounisios, C.; Ind, T.; Rasheed, S. Endometrial stromal sarcoma arising from polypoid endometriosis: Case report and literature review. Int. J. Surg. Case Rep., 2020, 72, 537-540.
[http://dx.doi.org/10.1016/j.ijscr.2020.06.062] [PMID: 32698283]
[8]
Efared, B.; Sidibé, I.S.; Erregad, F.; Hammas, N.; Chbani, L.; El Fatemi, H. Extra-uterine low grade endometrioid stromal sarcoma arising from ovarian endometriosis: A case report and review of the literature. Gynecol. Oncol. Res. Pract., 2019, 6, 2.
[http://dx.doi.org/10.1186/s40661-019-0067-7] [PMID: 30723546]
[9]
Ilanthodi, S.; Meghashree, V.; Pai, M.R. Primary ovarian endometrioid stromal sarcoma presenting with infertility. J. Clin. Diagn. Res., 2017, 11(3), ED05-ED07.
[http://dx.doi.org/10.7860/JCDR/2017/25013.9432] [PMID: 28511399]
[10]
Kilzieh, R.; Rakislova, N.; Torné, A.; Salvador, R.; Nadal, A.; Ordi, J.; Saco, A. Endometrial stromal sarcoma arising in colorectal endometriosis. Int. J. Gynecol. Pathol., 2017, 36(5), 433-437.
[http://dx.doi.org/10.1097/PGP.0000000000000351] [PMID: 27801759]
[11]
Back, J.A.; Choi, M.G.; Ju, U.C.; Kang, W.D.; Kim, S.M. A case of advanced-stage endometrial stromal sarcoma of the ovary arising from endometriosis. Obstet. Gynecol. Sci., 2016, 59(4), 323-327.
[http://dx.doi.org/10.5468/ogs.2016.59.4.323] [PMID: 27462602]
[12]
Wang, Q.; Zhao, X.; Han, P. Endometrial stromal sarcoma arising in colorectal endometriosis: A case report and review of the literature. Case Rep. Obstet. Gynecol., 2015, 2015534273.
[http://dx.doi.org/10.1155/2015/534273] [PMID: 25648532]
[13]
Lan, C.; Huang, X.; Lin, S.; Cai, M.; Liu, J. Endometrial stromal sarcoma arising from endometriosis: A clinicopathological study and literature review. Gynecol. Obstet. Invest., 2012, 74(4), 288-297.
[http://dx.doi.org/10.1159/000341706] [PMID: 22986788]
[14]
Alcázar, J.L.; Guerriero, S.; Ajossa, S.; Parodo, G.; Piras, B.; Peiretti, M.; Jurado, M.; Idoate, M.Á. Extragenital endometrial stromal sarcoma arising in endometriosis. Gynecol. Obstet. Invest., 2012, 73(4), 265-271.
[http://dx.doi.org/10.1159/000336522] [PMID: 22538201]
[15]
Foti, P.V.; Farina, R.; Palmucci, S.; Vizzini, I.A.A.; Libertini, N.; Coronella, M.; Spadola, S.; Caltabiano, R.; Iraci, M.; Basile, A.; Milone, P.; Cianci, A.; Ettorre, G.C. Endometriosis: Clinical features, MR imaging findings and pathologic correlation. Insights Imag., 2018, 9(2), 149-172.
[http://dx.doi.org/10.1007/s13244-017-0591-0] [PMID: 29450853]
[16]
Thomassin-Naggara, I.; Lamrabet, S.; Crestani, A.; Bekhouche, A.; Wahab, C.A.; Kermarrec, E.; Touboul, C.; Daraï, E. Magnetic resonance imaging classification of deep pelvic endometriosis: Description and impact on surgical management. Hum. Reprod., 2020, 35(7), 1589-1600.
[http://dx.doi.org/10.1093/humrep/deaa103] [PMID: 32619220]
[17]
Puliyath, G.; Nair, M.K. Endometrial stromal sarcoma: A review of the literature. Indian J. Med. Paediatr. Oncol., 2012, 33(1), 1-6.
[http://dx.doi.org/10.4103/0971-5851.96960] [PMID: 22754201]
[18]
Zang, Y.; Dong, M.; Zhang, K.; Gao, C.; Guo, F.; Wang, Y.; Xue, F. Hormonal therapy in uterine sarcomas. Cancer Med., 2019, 8(4), 1339-1349.
[http://dx.doi.org/10.1002/cam4.2044] [PMID: 30897294]
[19]
Dupont, N.C.; Disaia, P.J. Recurrent endometrial stromal sarcoma: Treatment with a progestin and gonadotropin releasing hormone agonist. Sarcoma, 2010, 2010, 353679.
[http://dx.doi.org/10.1155/2010/353679] [PMID: 20613993]
[20]
Altal, O.F.; Al Sharie, A.H.; Halalsheh, O.M.; Tashtush, N.; Shaban, S.; Alfaqih, M.; Aleshawi, A. Complete remission of advanced low-grade endometrial stromal sarcoma after aromatase inhibitor therapy: A case report. J. Med. Case Reports, 2021, 15(1), 262.
[http://dx.doi.org/10.1186/s13256-021-02838-x] [PMID: 33947445]
[21]
Leunen, M.; Breugelmans, M.; De Sutter, P.; Bourgain, C.; Amy, J.J. Low-grade endometrial stromal sarcoma treated with the aromatase inhibitor letrozole. Gynecol. Oncol., 2004, 95(3), 769-771.
[http://dx.doi.org/10.1016/j.ygyno.2004.07.063] [PMID: 15582003]
[22]
Sylvestre, V.T.; Dunton, C.J. Treatment of recurrent endometrial stromal sarcoma with letrozole: A case report and literature review. Horm. Cancer, 2010, 1(2), 112-115.
[http://dx.doi.org/10.1007/s12672-010-0007-9] [PMID: 21761354]
[23]
Yu, L.; Wang, L.; Tan, Y.; Hu, H.; Shen, L.; Zheng, S.; Ding, K.; Zhang, S.; Yuan, Y. Accuracy of magnetic resonance imaging in staging rectal cancer with multidisciplinary team: A single-center experience. J. Cancer, 2019, 10(26), 6594-6598.
[http://dx.doi.org/10.7150/jca.32685] [PMID: 31777588]

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