Rebegea Laura Florentina, Firescu Dorel, Anghel Rodica Marcela, Gales Laurentia, Ilie Ana Maria, Dumitru Mihaela Emilia, Craescu Mihaela, Niculet Elena, Tatu Alin Laurentiu, Cretu Mariana Stuparu, Lungu Mihaela, Neagu Anca Iulia
Department of Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galati, Romania.
Medical Clinical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galati, Romania.
Exp Ther Med. 2021 Dec;22(6):1456. doi: 10.3892/etm.2021.10891. Epub 2021 Oct 18.
Endometrial stromal sarcoma (ESS) is a rare tumor, predominantly occurring as a primary tumor of the uterus. Rare cases of primary extrauterine ESS (EESS) have been reported. Low-grade ESS (LG-ESS) is more common than high-grade ESS (HG-ESS). We present five cases of ESS and one case of EESS. All cases received external radiotherapy (EBRT) at the Radiotherapy Department of the Emergency Clinical Hospital 'Sfantul Apostol Andrei' Galati, during 2004-2020. Five cases underwent EBRT in two-dimensional (2D) technique and only one patient received EBRT with three-dimensinal conformational radiotherapy (3DCRT) technique with a linear accelerator, Elekta Synergy. Five patients were referred to postoperative radiotherapy after hysterectomy. The median age of the patients was 57.4 years. One patient was referred to radiotherapy with palliative intent. EESS localized in the retroperitoneum, in the para-aortic region, was identified in one 64-year-old patient with a personal history of hysterectomy and bilateral salpingo-oophorectomy in 1997; EESS was complicated with vertebral extension at the L1-L2 level and spinal cord compression syndrome. ESS represents a rare diagnosis and a high- or low-grade tumor profile is distinguished by immunohistochemistry (IHC) tests. Up to 30% of patients have EESS at presentation. The treatment of ESS is multimodal, its management requiring a multidisciplinary team, and it is different according to the primary tumor location and tumor staging. The role of adjuvant radiotherapy remains controversial in high-grade EESS and due to the rarity of these cases there are limited data concerning the efficacy of adjuvant EBRT available from prospective randomized control clinical trials.
子宫内膜间质肉瘤（ESS）是一种罕见肿瘤，主要表现为子宫原发性肿瘤。已有原发性子宫外ESS（EESS）的罕见病例报道。低级别ESS（LG-ESS）比高级别ESS（HG-ESS）更常见。我们报告了5例ESS和1例EESS。所有病例均于2004年至2020年期间在加拉茨“圣使徒安德烈”急诊临床医院放疗科接受了体外放疗（EBRT）。5例采用二维（2D）技术进行EBRT，仅1例患者使用直线加速器Elekta Synergy采用三维适形放疗（3DCRT）技术接受EBRT。5例患者在子宫切除术后接受术后放疗。患者的中位年龄为57.4岁。1例患者接受姑息性放疗。1例64岁有1997年子宫切除术和双侧输卵管卵巢切除术个人史的患者，其EESS位于腹膜后主动脉旁区域；EESS合并L1-L2水平椎体延伸和脊髓压迫综合征。ESS是一种罕见诊断，通过免疫组织化学（IHC）检测区分高级别或低级别肿瘤特征。高达30%的患者初诊时患有EESS。ESS的治疗是多模式的，其管理需要多学科团队，并且根据原发性肿瘤位置和肿瘤分期而有所不同。辅助放疗在高级别EESS中的作用仍存在争议，由于这些病例罕见，前瞻性随机对照临床试验中关于辅助EBRT疗效的可用数据有限。
