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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

doi: 10.1097/01.AOG.0000127942.91516.a2
Case Reports

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.

Advanced primary endometrial stromal sarcomas of the ovary can be treated successfully with complete tumor resection and progestational therapy.

Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, California

Address reprint requests to: Michael L. Berman, MD, University of California Irvine Medical Center, Chao Family Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 101 The City Drive, Orange, CA 92668; e-mail: mberman\@uci.edu

Received January 23, 2003. Received in revised form March 27, 2003. Accepted April 2, 2003.

© 2004 The American College of Obstetricians and Gynecologists