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Orbital metastasis of endocervical stromal sarcoma: a rare tumor and an uncommon metastasis.

Seker MM, Uslu AU, Ozer H, Seker A, Kacan T, Babacan N, Aker H, Elagoz S - Prz Menopauzalny (2014)

Bottom Line: An orbital mass was detected with magnetic resonance imaging.Orbital metastasis may be seen in ECSS patients.Although we have less knowledge about the choice of chemotherapeutic agents, ifosfamide and doxorubicin are effective in treating ECSS.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Medical Faculty, Cumhuriyet University, Sivas, Turkey.

ABSTRACT
Endocervical stromal sarcoma (ECSS) is a very rare uterine sarcoma. The most common presentation is pelvic mass and vaginal bleeding. The mainstay of treatment is surgery. There is no consensus on the adjuvant treatment. Relapses are usually in the pelvic and abdominal regions. To a lesser extent, lung, liver and bone metastases may be seen. A 46-year-old woman had total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) performed due to endometrial polyp and leiomyoma. Six months after the TAH-BSO, she was admitted to the hospital with cough and hemoptysis. A thoracic mass was detected, and a biopsy was done. The diagnosis was low-grade ECSS metastasis. One week after thoracotomy, she was admitted to the hospital with loss of vision in the left eye. An orbital mass was detected with magnetic resonance imaging. Endometrial and cervical pathology preparations were reassessed and were compatible with ECSS. We performed mammography, thorax, and abdomen and cranial imaging to rule out other malignancies that may cause lung and orbital metastasis. Partial remission was achieved with systemic chemotherapy and orbital radiotherapy. Orbital metastasis may be seen in ECSS patients. Although we have less knowledge about the choice of chemotherapeutic agents, ifosfamide and doxorubicin are effective in treating ECSS.

No MeSH data available.


Related in: MedlinePlus

Patient's orbital magnetic resonance imaging
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Figure 0002: Patient's orbital magnetic resonance imaging

Mentions: A 46-year-old female patient was admitted one year ago to the hospital with vaginal bleeding. During gynecologic examination, an endocervical polyp was detected and excised. After pathologic examination, the diagnosis was mesenchymal stromal polyps. After 4 months, she was admitted to the hospital with vaginal bleeding again. Thus, a total abdominal hysterectomy-bilateral salpingo oophorectomy (TAH-BSO) was performed. The diagnosis was mesodermal stromal polyp, chronic cervicitis and leiomyoma after pathologic examination (Fig. 1A). Six months after TAH-BSO, she was admitted to hospital with cough and hemoptysis. On chest computed tomography, a 61 mm × 54 mm lobulated contoured mass lesion was obliterating the lower lobe bronchus and surrounding the descending aorta; a biopsy was performed. The diagnosis was low-grade malign mesenchymal tumor with pathologic examination. One week after biopsy, loss of vision in the left eye developed. Orbital magnetic resonance imaging was performed, and a 30 mm × 20 mm × 30 mm lesion was detected involving the orbital apex and posterior cavernous sinus; it was infiltrating the neural foramen and extending to the sphenoid sinus and ethmoid cells in the anteromedial (Fig. 2).


Orbital metastasis of endocervical stromal sarcoma: a rare tumor and an uncommon metastasis.

Seker MM, Uslu AU, Ozer H, Seker A, Kacan T, Babacan N, Aker H, Elagoz S - Prz Menopauzalny (2014)

Patient's orbital magnetic resonance imaging
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4352913&req=5

Figure 0002: Patient's orbital magnetic resonance imaging
Mentions: A 46-year-old female patient was admitted one year ago to the hospital with vaginal bleeding. During gynecologic examination, an endocervical polyp was detected and excised. After pathologic examination, the diagnosis was mesenchymal stromal polyps. After 4 months, she was admitted to the hospital with vaginal bleeding again. Thus, a total abdominal hysterectomy-bilateral salpingo oophorectomy (TAH-BSO) was performed. The diagnosis was mesodermal stromal polyp, chronic cervicitis and leiomyoma after pathologic examination (Fig. 1A). Six months after TAH-BSO, she was admitted to hospital with cough and hemoptysis. On chest computed tomography, a 61 mm × 54 mm lobulated contoured mass lesion was obliterating the lower lobe bronchus and surrounding the descending aorta; a biopsy was performed. The diagnosis was low-grade malign mesenchymal tumor with pathologic examination. One week after biopsy, loss of vision in the left eye developed. Orbital magnetic resonance imaging was performed, and a 30 mm × 20 mm × 30 mm lesion was detected involving the orbital apex and posterior cavernous sinus; it was infiltrating the neural foramen and extending to the sphenoid sinus and ethmoid cells in the anteromedial (Fig. 2).

Bottom Line: An orbital mass was detected with magnetic resonance imaging.Orbital metastasis may be seen in ECSS patients.Although we have less knowledge about the choice of chemotherapeutic agents, ifosfamide and doxorubicin are effective in treating ECSS.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Medical Faculty, Cumhuriyet University, Sivas, Turkey.

ABSTRACT
Endocervical stromal sarcoma (ECSS) is a very rare uterine sarcoma. The most common presentation is pelvic mass and vaginal bleeding. The mainstay of treatment is surgery. There is no consensus on the adjuvant treatment. Relapses are usually in the pelvic and abdominal regions. To a lesser extent, lung, liver and bone metastases may be seen. A 46-year-old woman had total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) performed due to endometrial polyp and leiomyoma. Six months after the TAH-BSO, she was admitted to the hospital with cough and hemoptysis. A thoracic mass was detected, and a biopsy was done. The diagnosis was low-grade ECSS metastasis. One week after thoracotomy, she was admitted to the hospital with loss of vision in the left eye. An orbital mass was detected with magnetic resonance imaging. Endometrial and cervical pathology preparations were reassessed and were compatible with ECSS. We performed mammography, thorax, and abdomen and cranial imaging to rule out other malignancies that may cause lung and orbital metastasis. Partial remission was achieved with systemic chemotherapy and orbital radiotherapy. Orbital metastasis may be seen in ECSS patients. Although we have less knowledge about the choice of chemotherapeutic agents, ifosfamide and doxorubicin are effective in treating ECSS.

No MeSH data available.


Related in: MedlinePlus