Difference between revisions of "Endometrial stromal sarcoma"

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(→‎Microscopic: tweak some more)
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| Micro      = highly cellular islands of (tumour) cells with a wavy irregular border -- benign uterine smooth muscle between; tumour cells: high [[NC ratio]] and epithelioid, pallisade around thin blood vessels within the tumour
| Micro      = highly cellular islands of (tumour) cells with a wavy irregular border -- benign uterine smooth muscle between; tumour cells: high [[NC ratio]] and epithelioid, pallisade around thin blood vessels within the tumour
| Subtypes  =
| Subtypes  =
| LMDDx      = [[leiomyoma]] (cellular), [[endometrial stromal nodule]], [[Uterine leiomyosarcoma]].
| LMDDx      = [[leiomyoma]] (cellular), [[endometrial stromal nodule]], [[uterine leiomyosarcoma]]
| Stains    =
| Stains    =
| IHC        = CD10 +ve, H-caldesmin -ve, PR +/-ve, ER +/-ve
| IHC        = CD10 +ve, H-caldesmin -ve, PR +/-ve, ER +/-ve
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| Rads      =
| Rads      =
| Endoscopy  =
| Endoscopy  =
| Prognosis  =
| Prognosis  = good
| Other      =
| Other      =
| ClinDDx    = other [[uterine tumours]]
| ClinDDx    = other [[uterine tumours]]
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==General==
==General==
*Uncommon.<ref name=pmid20179433> {{Cite journal  | last1 = Chew | first1 = I. | last2 = Oliva | first2 = E. | title = Endometrial stromal sarcomas: a review of potential prognostic factors. | journal = Adv Anat Pathol | volume = 17 | issue = 2 | pages = 113-21 | month = Mar | year = 2010 | doi = 10.1097/PAP.0b013e3181cfb7c2 | PMID = 20179433 }}</ref>
*Uncommon.<ref name=pmid20179433> {{Cite journal  | last1 = Chew | first1 = I. | last2 = Oliva | first2 = E. | title = Endometrial stromal sarcomas: a review of potential prognostic factors. | journal = Adv Anat Pathol | volume = 17 | issue = 2 | pages = 113-21 | month = Mar | year = 2010 | doi = 10.1097/PAP.0b013e3181cfb7c2 | PMID = 20179433 }}</ref>
*Prognosis good.<ref name=pmid24146786></ref>
*Prognosis good<ref name=pmid24146786></ref> > 90% five year survival and > 85% ten year survival<ref name=pmid24184602>{{Cite journal  | last1 = Yoon | first1 = A. | last2 = Park | first2 = JY. | last3 = Park | first3 = JY. | last4 = Lee | first4 = YY. | last5 = Kim | first5 = TJ. | last6 = Choi | first6 = CH. | last7 = Bae | first7 = DS. | last8 = Kim | first8 = BG. | last9 = Lee | first9 = JW. | title = Prognostic factors and outcomes in endometrial stromal sarcoma with the 2009 FIGO staging system: A multicenter review of 114 cases. | journal = Gynecol Oncol | volume =  | issue =  | pages =  | month = Oct | year = 2013 | doi = 10.1016/j.ygyno.2013.10.029 | PMID = 24184602 }}</ref>


==Microscopic==
==Microscopic==
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*PR +/-ve.
*PR +/-ve.
*ER +/-ve.
*ER +/-ve.
*CD117 +ve (~80%).<ref>{{Cite journal  | last1 = Park | first1 = JY. | last2 = Kim | first2 = KR. | last3 = Nam | first3 = JH. | title = Immunohistochemical analysis for therapeutic targets and prognostic markers in low-grade endometrial stromal sarcoma. | journal = Int J Gynecol Cancer | volume = 23 | issue = 1 | pages = 81-9 | month = Jan | year = 2013 | doi = 10.1097/IGC.0b013e3182738361 | PMID = 23221606 }}</ref>


==Molecular==
==Molecular==

Revision as of 03:52, 17 November 2013

Endometrial stromal sarcoma
Diagnosis in short

Endometrial stromal sarcoma. H&E stain.
LM highly cellular islands of (tumour) cells with a wavy irregular border -- benign uterine smooth muscle between; tumour cells: high NC ratio and epithelioid, pallisade around thin blood vessels within the tumour
LM DDx leiomyoma (cellular), endometrial stromal nodule, uterine leiomyosarcoma
IHC CD10 +ve, H-caldesmin -ve, PR +/-ve, ER +/-ve
Molecular t(7;17)
Site uterus - see uterine tumours
Prevalence rare
Prognosis good
Clin. DDx other uterine tumours

Endometrial stromal sarcoma, abbreviated ESS, is a rare malignant mesenchymal tumour of the uterus.

It is also known as low-grade endometrial stromal sarcoma

General

  • Uncommon.[1]
  • Prognosis good[2] > 90% five year survival and > 85% ten year survival[3]

Microscopic

Features:

  • Highly cellular islands with a wavy irregular border.
    • Border has finger-like projections/tongue-like projections.
    • Benign uterine smooth muscle between islands of tumour cells.
  • Epithelioid cells.
  • High NC ratio.
  • Thin blood vessels within islands of cells.
    • Tumour cells pallisade around the vessels.

Notes:

  • Vaguely resembles the stroma of proliferative endometrium.
  • Low mitotic rate - predictive of good outcome.[2]

DDx:

Images

  • ESS - low mag. (WC/Nephron)

  • ESS - low mag. (WC/Nephron)

  • ESS - intermed. mag. (WC/Nephron)

  • ESS - high mag. (WC/Nephron)

  • ESS - very high mag. (WC/Nephron)

  • ESS. (WC)

  • Endometrial stromal sarcoma - low grade. (WC)

www:

IHC

Features:[5]

  • CD10 +ve.
  • H-caldesmin -ve.
  • PR +/-ve.
  • ER +/-ve.
  • CD117 +ve (~80%).[6]

Molecular

May be associated a recurrent translocation:[7]

  • t(7;17)(p15;q21).
    • JAZF1 - chromosome 7.[8]
    • SUZ12 - chromosome 17.[9]

See also

References

  1. ↑ Chew, I.; Oliva, E. (Mar 2010). "Endometrial stromal sarcomas: a review of potential prognostic factors.". Adv Anat Pathol 17 (2): 113-21. doi:10.1097/PAP.0b013e3181cfb7c2. PMID 20179433.
  2. ↑ 2.0 2.1 2.2 Cite error: Invalid <ref> tag; no text was provided for refs named pmid24146786
  3. ↑ Yoon, A.; Park, JY.; Park, JY.; Lee, YY.; Kim, TJ.; Choi, CH.; Bae, DS.; Kim, BG. et al. (Oct 2013). "Prognostic factors and outcomes in endometrial stromal sarcoma with the 2009 FIGO staging system: A multicenter review of 114 cases.". Gynecol Oncol. doi:10.1016/j.ygyno.2013.10.029. PMID 24184602.
  4. ↑ Baker, P.; Oliva, E. (Mar 2007). "Endometrial stromal tumours of the uterus: a practical approach using conventional morphology and ancillary techniques.". J Clin Pathol 60 (3): 235-43. doi:10.1136/jcp.2005.031203. PMID 17347285. http://jcp.bmj.com/content/60/3/235.full.
  5. ↑ Zhu, XQ.; Shi, YF.; Cheng, XD.; Zhao, CL.; Wu, YZ. (Jan 2004). "Immunohistochemical markers in differential diagnosis of endometrial stromal sarcoma and cellular leiomyoma.". Gynecol Oncol 92 (1): 71-9. PMID 14751141.
  6. ↑ Park, JY.; Kim, KR.; Nam, JH. (Jan 2013). "Immunohistochemical analysis for therapeutic targets and prognostic markers in low-grade endometrial stromal sarcoma.". Int J Gynecol Cancer 23 (1): 81-9. doi:10.1097/IGC.0b013e3182738361. PMID 23221606.
  7. ↑ Amant, F.; Moerman, P.; Cadron, I.; Hagemeijer, A.; Vergote, I.; Debiec-Rychter, M. (Mar 2003). "Endometrial stromal sarcoma with a sole t(X;17) chromosome change: report of a case and review of the literature.". Gynecol Oncol 88 (3): 459-62. PMID 12648605.
  8. ↑ Online 'Mendelian Inheritance in Man' (OMIM) 606246
  9. ↑ Online 'Mendelian Inheritance in Man' (OMIM) 606245
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