Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
BMJ Case Rep. 2021 Sep 20;14(9):e245099. doi: 10.1136/bcr-2021-245099.
Extrauterine endometrial stromal sarcomas (EUESSs) are rare tumours occurring without primary uterine involvement. They are classified as primary or secondary, depending on uterine involvement by stromal sarcomas. A 56-year-old woman who earlier underwent bilateral modified radical mastectomy for adenocarcinoma and total abdominal hysterectomy for endometrial stromal sarcoma, followed by tamoxifen therapy, presented with left loin pain. On evaluation, she had a left renal calculus with hydroureteronephrosis. Before percutaneous nephrolithotripsy, ureteroscopy revealed a polypoidal mass that was diagnosed as EUESS. The mass arose primarily within the ureteral lumen, with periureteric tissue uninvolved. She underwent left radical nephroureterectomy with adjuvant hormonal treatment. This is probably the first case of EUESS arising de novo from within the ureteral lumen without endometriosis, to be reported in medical literature. Immunohistochemistry facilitates earlier diagnosis. Cytoreductive surgery is the definitive treatment and multidisciplinary approach helps in overall survival of the patient.
子宫外子宫内膜间质肉瘤（EUESS）是一种罕见的肿瘤，无原发性子宫受累。它们根据是否由间质肉瘤引起子宫受累而分为原发性或继发性。一位 56 岁的女性，曾因腺癌接受双侧改良根治性乳房切除术，因子宫内膜间质肉瘤行全子宫切除术，随后接受他莫昔芬治疗，现出现左侧腰痛。检查时，她有左肾结石伴肾盂积水。在进行经皮肾镜碎石术之前，输尿管镜检查显示有一个息肉样肿块，诊断为 EUESS。该肿块主要发生在输尿管腔内，周围输尿管组织不受累。她接受了左肾输尿管切除术和辅助激素治疗。这可能是首例在无子宫内膜异位症的情况下，原发于输尿管腔内的 EUESS 病例，在医学文献中报道。免疫组织化学有助于早期诊断。减瘤手术是明确的治疗方法，多学科方法有助于提高患者的总体生存率。
