Endometrial stromal sarcoma of the uterus with malignant thrombosis of the iliac and femoral veins: Case report and review of literature

Abstract

A case report of endometrial stromal sarcoma is presented. A 37 year old patient was admitted with a history of excessive bleeding per vaginum during menstruation and lump in abdomen for the past 6-7 months which was found to be about 24 weeks pregnancy size. On opening the abdomen for hysterectomy the uterus showed a growth extending into the left adnexa, sigmoid mesocolon, and left parametrium. During surgery there was accidental transection of the left ureter and external iliac vein which showed extensive thrombus. As total hysterectomy was not possible, subtotal hysterectomy with bilateral salpingo-oophorectomy was performed, with D-J stenting of the ureter and ligation of the external iliac vein. Postoperatively the diagnosis of thrombosis of the internal iliac, external iliac, femoral and popliteal veins was established by CT scan and Doppler imaging. Histopathology showed endometrial stromal sarcoma.