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Obstetrics & Gynecology:
Case Reports

Surgical Cytoreduction and Hormone Therapy of an Advanced Endometrial Stromal Sarcoma of the Ovary

Geas, Felicia L. MD; Tewari, Devansu S. MD; Rutgers, Joanne K. L. MD; Tewari, Krishnansu S. MD; Berman, Michael L. MD

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Abstract

BACKGROUND: Primary endometrial stromal sarcomas of the ovary are rare gynecologic malignancies. We report a disseminated case of this tumor arising from ovarian endometriosis.

CASE: A 45-year-old woman presented with an abdominal pelvic mass and an elevated CA 125. Exploration showed extensive tumor spread from the ovaries to the upper abdomen. Surgery included a total hysterectomy, bilateral salpingo-oophorectomy, splenectomy, partial gastrectomy, partial pancreatectomy, transverse colectomy, appendectomy, and omentectomy. Final pathology showed a low-grade endometrial stromal sarcoma of the ovary arising from foci of endometriosis. Megestrol acetate was initiated, and she is currently without evidence of disease.

CONCLUSION: This is an advanced case of a primary low-grade endometrial stromal sarcoma of the ovary arising from endometriosis managed by total resection and progestational therapy.

© 2004 The American College of Obstetricians and Gynecologists

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