Endometrial polypoid fibrosarcoma

Abstract

This report is given for two reasons. First, there was a distinct discrepancy in the clinical diagnosis and the microscopic report in a case of recurring endometrial polyposis. As proved eventually, at the time of removal of the uterus, the clinical diagnosis of sarcoma was correct. Second, we feel that we are dealing with a definite clinical and anatomic picture which, apparently, is not sufficiently known. From the experience in our own laboratory, corroborated by the relative paucity of reported observations similar to ours, this disease, which clinically may be designated best as recurring massive endometrial polyposis of elephantiastic character, apparently is relatively rare. It was not until the uterus was removed that the clinical diagnosis of sarcoma could be confirmed histologically. At the same time, in spite of reported recurring endometrial polyps over a period of three and one-half years, there was no clear gross evidence of any actual invasive growth of this endometrial sarcoma into the myometrium. Even in the polypous tumor material removed in fair-sized pieces two months previous to the extirpation of the uterus, a definite diagnosis of sarcoma could not be made from a large number of sections taken from different parts. Our diagnosis was confirmed by Robert Meyer who was kind enough to lend us his most valuable support.We are in the fortunate position of being able to correlate all histologic findings secured at different times over a period of three and one-half years, with the final picture taken from the extirpated uterus.