J Korean Med Sci.  2009 Jun;24(3):529-531. 10.3346/jkms.2009.24.3.529.

Endometrial Stromal Sarcoma Presenting as Prevesical Mass Mimicking Urachal Tumor

• Jung SI
• Shin SS
• Choi C
• Hwang EC
• Kim SO
• Kang TW

• KMID: 1779177
• DOI: http://doi.org/10.3346/jkms.2009.24.3.529

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.

Keyword

Sarcoma, Endometrial Stromal; Endometriosis

MeSH Terms

Diagnosis, Differential
Endometrial Neoplasms/*diagnosis/pathology/ultrasonography
Endometriosis/diagnosis
Female
Humans
Hysterectomy
Middle Aged
Sarcoma, Endometrial Stromal/*diagnosis/pathology/ultrasonography
Urachus/abnormalities
Urinary Bladder Neoplasms/diagnosis

Figure

• 

  Fig. 1 Imaging studies. (A) Ultrasonograhy shows heterogeneous hyperechoic pelvic mass. (B) Magnetic resonance imaging sagittal T2-weighted image shows well-defined hyperintense mass (arrow) in prevesical space and sagittal T1-weighted gadolinium-enhanced image shows homogeneous enhancement of the mass (arrow).

• 

  Fig. 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.

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