A case report of extrauterine lowª²grade endometrial stromal sarcoma and review of literatures

    HUI Yanª²Ping, GUO Shuangª²Ping, WANG Yingª²Mei, CHEN Wanª²Lu

    Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi¡¯an 710033, China

    ¡¾Abstract¡¿ AIM: To report a case of primary extrauterine endometrial stromal sarcoma (ESS) and discuss the morphologic and immunohistochemical features with a review of recent literatures. METHODS: The clinical characteristics, histological features and immunological properties of ESS were analyzed retrospectively using routine HE staining, transmission electron microscopic (TEM) and immunohistochemical methods. RESULTS: The reported case of primary extrauterine ESS in this article presented lesions in multiple organs and multiple foci, involving right ovary, appendix, colon and greater omentum. Islands of endometrial tissue with wellª²formed glands and stroma were found in the case. Histologically, the primary extrauterine ESS was characterized by an infiltrative and diffuse proliferation of uniform round or oval cells, abundant small vessels, low mitotic activity, the presence of foam cells and vascular invasion. TEM revealed that the tumor cells resembled normal proliferativeª²phase endometrial stromal cells and they showed variable degrees of smooth muscle differentiation and fibroblast differentiation. Immunohistochemically, the tumor cells were diffusely stained for vimentin, desmin, EMA, estrogen receptor (ER) and progesterone receptor (PR), but not stained for CK ......