Abstract
A case of a 64 year old woman with a tumour of the uterus is reported. The patient presented with postmenopausal bleeding and subsequently underwent total hysterectomy and bilateral salpingo-oophorectomy. Sections of the tumour showed a low grade endometrial stromal sarcoma coexisting with areas consistent with high grade sarcoma. The sarcoma cells, in both the low and high grade areas, were positive for vimentin and negative for desmin and cytokeratin on immunohistochemistry. While the sarcoma cells in the low grade region showed immunoreactivity for oestrogen and progestogen receptors, those in the high grade region did not. Using chromosome in situ hybridisation, the low grade portion of the sarcoma was diploid for chromosomes X, 11, 12, and 17, whereas the more anaplastic areas were aneuploid for these chromosomes. This case may represent an example of high grade endometrial stromal sarcoma arising by dedifferentiation from a low grade stromal sarcoma. Adequate sampling is important in identifying such anaplastic changes as the origin of the tumour will affect patient management.
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- Cheung A. N., Sit A. S., Chung L. P., Ngan H. Y., O'Hanlan K., Wong L. C., Ma H. K. Detection of heterozygous XY complete hydatidiform mole by chromosome in situ hybridization. Gynecol Oncol. 1994 Dec;55(3 Pt 1):386–392. doi: 10.1006/gyno.1994.1311. [DOI] [PubMed] [Google Scholar]
- Chumas J. C., Patsner B., Mann W. J. High-grade pelvic sarcoma after radiation therapy for low-grade endometrial stromal sarcoma. Gynecol Oncol. 1990 Mar;36(3):428–431. doi: 10.1016/0090-8258(90)90157-g. [DOI] [PubMed] [Google Scholar]
- Meis J. M. "Dedifferentiation" in bone and soft-tissue tumors. A histological indicator of tumor progression. Pathol Annu. 1991;26(Pt 1):37–62. [PubMed] [Google Scholar]
- Sabini G., Chumas J. C., Mann W. J. Steroid hormone receptors in endometrial stromal sarcomas. A biochemical and immunohistochemical study. Am J Clin Pathol. 1992 Mar;97(3):381–386. doi: 10.1093/ajcp/97.3.381. [DOI] [PubMed] [Google Scholar]
- Smith M. L., Faaborg L. L., Newland J. R. Dedifferentiation of endolymphatic stromal myosis to poorly differentiated uterine stromal sarcoma. Gynecol Oncol. 1980 Feb;9(1):108–113. doi: 10.1016/0090-8258(80)90015-3. [DOI] [PubMed] [Google Scholar]
- Thatcher S. S., Woodruff J. D. Uterine stromatosis: a report of 33 cases. Obstet Gynecol. 1982 Apr;59(4):428–434. [PubMed] [Google Scholar]