Cancer Res Treat.  2015 Oct;47(4):958-962. 10.4143/crt.2014.154.

A Case of Metastatic Low-Grade Endometrial Stromal Sarcoma Treated with Letrozole after Ovarian Ablation by Radiotherapy

• Yang KH
• Shin JA
• Jung JH
• Jung HW
• Lee HR
• Chang S
• Park JY
• Yi SY

• KMID: 2403419
• DOI: http://doi.org/10.4143/crt.2014.154

Abstract

A 50-year-old woman was admitted to our hospital due to multiple lung nodules detected incidentally on a chest X-ray. A video-assisted thoracoscopic lung biopsy revealed low-grade endometrial stromal sarcoma (LG-ESS). She had undergone a simple hysterectomy 1 year earlier owing to a diagnosis of adenomyosis. A review of her previous hysterectomy specimen showed not endometriosis but LG-ESS. According to the patient's levels of serum follicle stimulating hormone and estradiol, she was in the premenopausal state with retained and normally functioning ovaries. She then underwent ovarian ablation by radiotherapy, after which she was administered 2.5 mg of letrozole once per day. Three months later, the size of the metastatic nodules in both lungs had decreased. The patient was followed up for 24 months while continuing on letrozole, and maintained a partial remission. We report herein on a case of metastatic LG-ESS treated with letrozole after ovarian ablation by radiotherapy.

Keyword

Endometrial stromal sarcoma; Endometrial stromal tumors; Letrozole; Ovarian ablation

MeSH Terms

Adenomyosis
Biopsy
Diagnosis
Endometrial Stromal Tumors
Endometriosis
Estradiol
Female
Follicle Stimulating Hormone
Humans
Hysterectomy
Lung
Middle Aged
Ovary
Radiotherapy*
Sarcoma, Endometrial Stromal*
Thorax
Estradiol
Follicle Stimulating Hormone

Figure

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  Fig. 1. Microscopic findings on metastatic lung nodules. The tumors show perivascular whirling proliferation of ovoid and short spindle cells with scant-to-moderate amounts of eosinophilic cytoplasm and indistinct cell borders (A, H&E staining, ×100; B, H&E staining, ×400). The tumor cells on immunohistochemical staining for CD 10 (C, ×400), estrogen receptor (D, ×400) and progesterone receptor show a positive reaction.

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  Fig. 2. (A, B) Initial chest computed tomography scans showing multiple metastatic nodules in both lungs. (C, D) The patient was treated with letrozole, and, 3 months later, the size of the metastatic nodules in both lungs had decreased, indicating a partial response.

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