College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Gulf J Oncolog. 2021 Sep;1(37):95-98.
Endometrial Stromal Sarcoma (ESS) are very uncommon malignant tumors that make around 0.2% of the entire uterine related malignancies. They represent the endometrial stromal cells in the proliferative stage. The annual incidence of ESS is 1-2 per million women. We present an unusual case of ESS, which originates from the uterine artery through the Inferior Vena Cava (IVC) and extends to the right atrium. A 48 years old woman presented with menorrhagia and right flank pain for seven months. Physical examination was normal except for a palpable suprapubic mass. Computed tomography (CT) showed the right gonadal vein and IVC tumoral thrombus extending into the right atrium. An echocardiogram and Transesophygeal echocardiogram revealed a large non-mobile echogenic density in the right atrium. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Extensive myometrial and vascular invasion was noted along with the extensive lymphovascular invasion of the uterus. Eventually, distal IVC resections were done, and there was no chance to remove the tumor because it was too attached and invaded the IVC filter. Owing to the unresectability of the tumor, the patient was assigned for palliative chemotherapy. Keywords: Endometrial Stromal Sarcoma, Right Atrium, Inferior Vena Cava, Spindle Cell Sarcoma.
子宫内膜间质肉瘤（ESS）是非常罕见的恶性肿瘤，约占所有子宫相关恶性肿瘤的 0.2%。它们代表增殖期的子宫内膜间质细胞。ESS 的年发病率为每百万女性 1-2 例。我们报告了一例起源于子宫动脉、通过下腔静脉（IVC）并延伸至右心房的 ESS 不常见病例。一名 48 岁女性因月经过多和右腰痛 7 个月就诊。除了可触及耻骨上肿块外，体格检查正常。计算机断层扫描（CT）显示右侧性腺静脉和 IVC 肿瘤血栓延伸至右心房。超声心动图和经食道超声心动图显示右心房内有一个大的非活动回声密度。行全子宫切除术加双侧附件切除术。广泛的子宫肌层和血管侵犯，以及子宫广泛的淋巴血管侵犯。最终，进行了 IVC 远端切除术，但由于肿瘤附着并侵犯 IVC 过滤器，无法切除肿瘤。由于肿瘤无法切除，患者被分配进行姑息化疗。关键词：子宫内膜间质肉瘤、右心房、下腔静脉、梭形细胞肉瘤。
