An Unusual Missed Case of Endometrial Stromal Sarcoma

Abstract

Endometrial stromal sarcomas are rare uterine malignant tumours of mesodermal origin. The diagnosis is usually made post-operatively. The usual presentation is abnormal vaginal bleeding, abdominal lump and mild lower abdominal pain. In this case report, we present a case of low-grade endometrial stromal sarcoma where patient was initially thought to have fibroid uterus with cystic degenerative changes and underwent vaginal myomectomy on two occasions within a span of 4 months. Histopathology on the second occasion showed low-grade endometrial stromal cell sarcoma. Hence she underwent extrafascial total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by continuous high-dose progestogen treatment.