A well circumscribed uterine endometrial stromal tumor with smooth muscle differentiation recurred as a low grade endometrial stromal sarcoma: Is tumor margin enough for the diagnosis?

摘要

Differential diagnosis between the endometrial stromal nodule and the endometrial stromal sarcoma (ESS) is important for the management of patients; however, histological findings of the two lesions except the margins are not quite distinctive. Currently, diagnosis of endometrial stromal tumor with smooth muscle differentiation usually follows the diagnostic criteria of endometrial stromal tumors, and the myoin-filtrative tumor margin by thorough examination is only important to diagnose ESS. However, when a smooth muscle differentiation occurs at the periphery of ESS, the tumor forms a well defined border, thus, applicability of margin status as the diagnostic criteria becomes ambiguous. We describe this case to discuss the significance of margin status in the diagnosis of endometrial stromal sarcoma with smooth muscle differentiation.