Endometrial Stromal Sarcoma With Hyalinizing Giant Rosettes and Separate Leiomyoma With Palisading Nuclei in the Same Uterus

摘要

Examination of a simple hysterectomy in a 46-year-old woman performed for abnormal uterine bleeding revealed a low-grade endometrial stromal sarcoma with smooth muscle differentiation and lymphatic invasion. Hyalinized giant collagen rosette-like structures were seen similar to those described in the so-called hyalinizing spindle-cell tumor with giant rosettes (now recognized as a variant of low-grade fibromyxoid sarcoma). These abutted CDIO-positive endometrial-type stromal cells (Figures 1 and 2). The centrally hyalinized collagen rosette or starburst-like structure of this case is characteristic of endometrial stromal tumors with smooth muscle differentiation but by no means pathognomonic. The phenomenon was first described by Evans and further characterized by Oliva et al.