Department of Surgery, Wonkwang University Hospital, Iksan, Korea.
Korean J Gastroenterol. 2020 Dec 25;76(6):322-326. doi: 10.4166/kjg.2020.114.
Low-grade endometrial stromal sarcoma (LG-ESS) is a very rare mesenchymal neoplasm of the uterus. LG-ESS can recur or metastasize to extrauterine sites, such as the pelvis, peritoneal cavity, and vagina, but rarely to the lung, liver, heart, bone, and colon. A 42-year-old female patient was transferred from an outside clinic for an evaluation of constipation. EUS revealed a 5 cm hypoechoic lesion with a regular margin, probably arising from the 4th layer (muscular propria) at the sigmoid colon level. CT revealed a 7-cm homogenous enhancing mass lesion at the pelvic cavity and multiple enlarged lymph nodes in the sigmoid mesocolon. The patient underwent an anterior resection, and the diagnosis based on the biopsy result was LG-ESS. After a multidisciplinary discussion, she underwent a bilateral salpingo-oophorectomy. Small nodules found in the endometrium were identified as LG-ESS by a biopsy. This paper reports a case of metastatic LG-ESS presenting as a solitary sigmoid tumor without intrauterine lesions through preoperative examinations and discusses the characteristics of this neoplasm with reference to the relevant literature.
低度子宫内膜间质肉瘤（LG-ESS）是一种非常罕见的子宫间叶性肿瘤。LG-ESS 可复发或转移至子宫外部位，如骨盆、腹腔和阴道，但很少转移至肺、肝、心脏、骨和结肠。一位 42 岁女性患者因便秘从外院转入进行评估。EUS 显示乙状结肠水平 4 层（固有肌层）有一个 5cm 的低回声病变，边界规则。CT 显示盆腔有一个 7cm 的均质强化肿块病变，乙状结肠系膜有多枚增大的淋巴结。患者接受了前切除术，活检结果诊断为 LG-ESS。经过多学科讨论，她接受了双侧输卵管卵巢切除术。子宫内膜中的小结节通过活检被确定为 LG-ESS。本文报告了一例术前检查表现为孤立性乙状结肠肿瘤而无宫内病变的转移性 LG-ESS 病例，并结合相关文献讨论了这种肿瘤的特征。
