obsolete stromal sarcoma

Common Signs and Symptoms of Endometrioid Stromal Sarcoma (ESS)

Endometrioid stromal sarcoma (ESS) is a rare type of cancer that affects the uterus. The symptoms can vary from person to person, but here are some common signs and symptoms associated with ESS:

• Abnormal uterine bleeding: This is one of the most common symptoms of ESS, where women experience irregular or heavy menstrual bleeding [1].
• Pelvic pressure: Some women may feel a sensation of pelvic pressure or fullness due to the tumor growing in the uterus [7].
• Enlarged uterus: In some cases, the uterus may become enlarged due to the growth of the tumor [7].
• Abdominal pain/distension: Women with ESS may experience abdominal pain or distension as the tumor grows and puts pressure on surrounding tissues [1].

Other Possible Symptoms

While not as common, other symptoms that may be associated with ESS include:

• Frequent urination: Some women may experience frequent urination due to the tumor pressing on the bladder [1].
• Vaginal bleeding: Women with ESS may experience vaginal bleeding or spotting between periods [3].

Important Note

It's essential to note that these symptoms can be non-specific and similar to those experienced by women with other gynecological conditions. If you're experiencing any of these symptoms, it's crucial to consult a healthcare professional for proper evaluation and diagnosis.

References:

[1] Symptoms include abnormal uterine bleeding, abdominal pain/distension, and frequent urination. The exact cause is unknown, and most cases occur sporadically. It ...

[3] by FC Thiel · 2018 · Cited by 79 — These tumors often become apparent through pathologic vaginal bleeding, sometimes also combined with uterine enlargement and associated symptoms ...

[7] Mar 11, 2024 — Typical clinical presentations of ESS include the following: abnormal uterine bleeding, pelvic pressure, enlarged uterus, and abdominal ...

Diagnostic Tests for Endometrial Stromal Sarcoma

Endometrial stromal sarcoma (ESS) is a rare type of cancer that arises from the connective tissue of the uterus. Accurate diagnosis relies on recognizing characteristic histologic and cytologic features, including architecture, stromal characteristics, vascular patterns, and cellular morphology [7][8]. The following diagnostic tests are used to diagnose ESS:

• Histopathological examination: A biopsy or surgical specimen is examined under a microscope to identify the presence of atypical cells resembling endometrial stromal cells. This test is considered the gold standard for diagnosing ESS [10].
• Imaging studies: Imaging tests such as CT scans, MRI, and ultrasound are used to evaluate the extent of tumor spread and involvement of surrounding tissues [11]. A CT scan uses x-rays to make detailed cross-sectional images of your body, which can help identify if the sarcoma has spread to other organs like the lungs, liver, or lymph nodes [11].
• Molecular testing: Molecular tests such as FISH (Fluorescence In Situ Hybridization) or NGS (Next-Generation Sequencing) are used to detect genetic alterations in the tumor cells. These tests can help identify specific mutations that may be associated with ESS [4].

Diagnostic Challenges

Diagnosing ESS can be challenging due to its rarity and similarity in appearance to other types of uterine tumors. Accurate diagnosis requires a combination of histopathological examination, imaging studies, and molecular testing.

• Distinguishing from other uterine tumors: ESS must be distinguished from other types of uterine tumors, such as leiomyosarcoma or undifferentiated endocervical sarcoma [5].
• Identifying specific genetic alterations: Molecular tests can help identify specific genetic alterations associated with ESS, but these tests are not always available or reliable.

References

[4] FISH or NGS testing is available for detection of CIC rearrangements (DNA) or fusions (RNA) from various labs and is listed as “desirable” by the WHO. [7] Accurate diagnosis relies first upon recognition of characteristic histologic and cytologic features, including architecture, stromal characteristics, vascular patterns, and cellular morphology. [8] Accurate diagnosis relies first upon recognition of characteristic histologic and cytologic features, including architecture, stromal characteristics, vascular patterns, and cellular morphology. [10] HG-ESS is a rare type of ESS that accounts for approximately 5% of all ESS cases.

Treatment Options for Obsolete Stromal Sarcoma

Obsolete stromal sarcoma, also known as endometrial stromal sarcoma, is a rare type of cancer that affects the uterus. While there are no specific treatment options listed in the search results, we can infer some potential treatments based on related information.

• Aromatase Inhibitors: Aromatase inhibitors, such as letrozole and anastrozole, have been suggested as a possible treatment for uterine sarcoma (1). These drugs work by blocking the production of estrogen, which may help slow down the growth of cancer cells.
• Progesterone: Progesterone has also been explored as a potential treatment for uterine sarcoma (1). While its exact mechanism is unclear, it's thought to have some anti-cancer properties.
• Gonadotropin-Releasing Hormone Agonists: Gonadotropin-releasing hormone agonists, such as leuprolide and goserelin, can help reduce estrogen levels in the body (1). This may be beneficial for treating uterine sarcoma.

Other Treatment Options

While these treatments are not specifically mentioned in the search results, they have been explored in other contexts:

• Ifosfamide: Ifosfamide is a chemotherapy drug that has shown activity against endometrial stromal sarcomas (2).
• Imatinib: Imatinib, a tyrosine kinase inhibitor, has long been the standard initial treatment for people with advanced gastrointestinal stromal tumors (GIST) (3). However, its effectiveness in treating obsolete stromal sarcoma is unclear.
• Neoadjuvant Therapy: Neoadjuvant therapy, which involves administering chemotherapy or other treatments before surgery, may be beneficial for patients with marginally resectable tumors or those who are not good candidates for surgery (5).

Current Research

Research on the treatment of obsolete stromal sarcoma is ongoing. A study published in 2022 explored the use of aromatase inhibitors in treating low-grade endometrial stromal sarcomas (4). Another study from 2015 discussed possible combination therapies, including ifosfamide, doxorubicin, and cisplatin (6).

References

(1) H RYU · 2015 · Cited by 25 (2) Ifosfamide: a chemotherapy drug with activity against endometrial stromal sarcomas (3) Imatinib: the standard initial treatment for advanced GIST (4) Aromatase inhibitors in low-grade endometrial stromal sarcomas (5) Neoadjuvant therapy for marginally resectable tumors (6) Combination therapies for uterine sarcoma

The differential diagnosis of endometrial stromal sarcoma (ESS) involves distinguishing it from other benign gynecologic diseases before surgery. According to various medical sources [1, 3, 7], the grade is the most important factor in differentiating ESS from other conditions.

Some of the key factors to consider in the differential diagnosis of ESS include:

• Mitotic index: A mitotic index of < 10/10 high-powered fields (HPF) can help differentiate low-grade ESS from other benign gynecologic diseases [4].
• Histological features: The presence of uniform oval or spindle-shaped neoplastic cells invading the myometrium is characteristic of ESS [11].
• Imaging studies: Imaging studies such as ultrasound, MRI, and CT scans can help identify the location and extent of the tumor.
• Clinical presentation: The clinical presentation of ESS can vary, but it often presents with symptoms such as pelvic pain, irregular vaginal bleeding, or a palpable abdominal mass.

It's worth noting that the differential diagnosis of ESS from other benign gynecologic diseases is often difficult [1, 7]. Therefore, a thorough evaluation and consultation with a specialist are essential to ensure accurate diagnosis and treatment.

References:

[1] The differential diagnosis of ESSs from other benign gynecologic diseases before surgery is often difficult. Though it is known that grade is the most important factor in differentiating ESS from other conditions. [3] by EJ Nam · 2008 · Cited by 13 — The differential diagnosis of ESSs from other benign gynecologic diseases before surgery is often difficult. Though it is known that grade is the most ... [4] by FC Thiel · 2018 · Cited by 79 — These tumors were initially differentiated mainly on the basis of mitoses per 10 high-powered fields (HPF). A mitotic index of < 10/10 HPF was ... [7] The differential diagnosis of ESSs from other benign gynecologic diseases before surgery is often difficult. Though it is known that grade is the most important factor in differentiating ESS from other conditions. [11] Endometrial stromal sarcoma uniform oval or spindle shaped neoplastic cells invading myometrium.