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Endometrial stromal sarcoma presenting as prevesical mass mimicking urachal tumor.

Jung SI, Shin SS, Choi C, Hwang EC, Kim SO, Kang TW - J. Korean Med. Sci. (2009)

Bottom Line: Since malignant transformation of urachal remnants was possible, the mass was suspected to be a urachal tumor.Extraction of the mass was performed, and the histopathologic diagnosis was low-grade ESS.In summary, prevesical tumor is rare but in patients with endometriosis, we suggest endometriosis and its possible malignant changes should be taken into account in the differential diagnosis of prevesical mass.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT
Endometrial stromal sarcoma (ESS) is a mesenchymal neoplasm that usually occurs as a primary tumor of the uterine corpus, but rarely arises in other sites, such as the ovary, pelvic cavity, mesentery, omentum and intestine. Herein, we present a rare case of low-grade ESS presented as prevesical mass. A 60-yr-old woman who had undergone total hysterectomy for endometriosis eleven years ago was presented with incidentally detected prevesical pelvic mass. Since malignant transformation of urachal remnants was possible, the mass was suspected to be a urachal tumor. Extraction of the mass was performed, and the histopathologic diagnosis was low-grade ESS. In summary, prevesical tumor is rare but in patients with endometriosis, we suggest endometriosis and its possible malignant changes should be taken into account in the differential diagnosis of prevesical mass.

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Pathologic findings. (A) The tumor cells are distributed around the small vessels. (B) Tumor cells have oval nuclei and scanty cytoplasm with ill-defined cell borders. The cells are atypical and mitotic figures are noted.
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Figure 2: Pathologic findings. (A) The tumor cells are distributed around the small vessels. (B) Tumor cells have oval nuclei and scanty cytoplasm with ill-defined cell borders. The cells are atypical and mitotic figures are noted.

Mentions: Grossly, well-circumscribed yellowish tumors were 4.5×2.5×2 cm, 1.5×1×1 cm in size, respectively. Microscopically, the lesion was characterized infiltrating nest of tumor cells. The tumor consisted of relatively large cells resembling those of the endometrial stroma, which encircled small vessels (Fig. 2A). Tumor cell nuclei was round to ovoid and a small amount of cytoplasm was present. Mitotic activity was less than 10 mitotic figures per 10 high power field (HPF) (Fig. 2B). Immunohistochemically, the tumor cells were positive for CD10 but negative for cytokeratin. Most of the cells were also negative for estrogen receptor, and positive for progesterone receptor (data not shown). Based on these findings, a low-grade ESS was diagnosed. Her postoperative recovery was uneventful. She was free of symptoms at the last follow-up, 15 months after the abdominal surgery, with no evidence of recurrence.


Endometrial stromal sarcoma presenting as prevesical mass mimicking urachal tumor.

Jung SI, Shin SS, Choi C, Hwang EC, Kim SO, Kang TW - J. Korean Med. Sci. (2009)

Pathologic findings. (A) The tumor cells are distributed around the small vessels. (B) Tumor cells have oval nuclei and scanty cytoplasm with ill-defined cell borders. The cells are atypical and mitotic figures are noted.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698206&req=5

Figure 2: Pathologic findings. (A) The tumor cells are distributed around the small vessels. (B) Tumor cells have oval nuclei and scanty cytoplasm with ill-defined cell borders. The cells are atypical and mitotic figures are noted.
Mentions: Grossly, well-circumscribed yellowish tumors were 4.5×2.5×2 cm, 1.5×1×1 cm in size, respectively. Microscopically, the lesion was characterized infiltrating nest of tumor cells. The tumor consisted of relatively large cells resembling those of the endometrial stroma, which encircled small vessels (Fig. 2A). Tumor cell nuclei was round to ovoid and a small amount of cytoplasm was present. Mitotic activity was less than 10 mitotic figures per 10 high power field (HPF) (Fig. 2B). Immunohistochemically, the tumor cells were positive for CD10 but negative for cytokeratin. Most of the cells were also negative for estrogen receptor, and positive for progesterone receptor (data not shown). Based on these findings, a low-grade ESS was diagnosed. Her postoperative recovery was uneventful. She was free of symptoms at the last follow-up, 15 months after the abdominal surgery, with no evidence of recurrence.

Bottom Line: Since malignant transformation of urachal remnants was possible, the mass was suspected to be a urachal tumor.Extraction of the mass was performed, and the histopathologic diagnosis was low-grade ESS.In summary, prevesical tumor is rare but in patients with endometriosis, we suggest endometriosis and its possible malignant changes should be taken into account in the differential diagnosis of prevesical mass.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT
Endometrial stromal sarcoma (ESS) is a mesenchymal neoplasm that usually occurs as a primary tumor of the uterine corpus, but rarely arises in other sites, such as the ovary, pelvic cavity, mesentery, omentum and intestine. Herein, we present a rare case of low-grade ESS presented as prevesical mass. A 60-yr-old woman who had undergone total hysterectomy for endometriosis eleven years ago was presented with incidentally detected prevesical pelvic mass. Since malignant transformation of urachal remnants was possible, the mass was suspected to be a urachal tumor. Extraction of the mass was performed, and the histopathologic diagnosis was low-grade ESS. In summary, prevesical tumor is rare but in patients with endometriosis, we suggest endometriosis and its possible malignant changes should be taken into account in the differential diagnosis of prevesical mass.

Show MeSH
Related in: MedlinePlus