Alswiket Hasan M, Aldar Hawra M, Alamry Ryad F, Albahrani Zahra S, Alismail Maram A, Elghoneimy Yasser A
College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Department of Cardiac Surgery, King Fahad University Hospital, Dammam, SAU.
Cureus. 2022 Dec 21;14(12):e32807. doi: 10.7759/cureus.32807. eCollection 2022 Dec.
Endometrial stromal sarcoma (ESS) is a rare, malignant tumor of the endometrium. Low-grade endometrial stromal sarcoma (LG-ESS) is a less aggressive subtype of ESS that rarely metastasizes to the heart and large blood vessels. In the present study, we report a case of recurrent LG-ESS after treating the initial mass in the uterus six years ago in a 49-year-old female who presented with a four-month history of dyspnea and easy fatigability. Investigations revealed a right pulmonary embolism, suspicious right psoas muscle mass, and a large inferior vena cava (IVC) thrombus. One month later, she presented with multiple gastrointestinal symptoms and weight loss. Investigations then showed the development of a new right atrial mass, infra-diaphragmatic metastatic lymphadenopathy, progression of the presacral soft tissue component, invasion of the ileal bowel loop, and a tumoral thrombus in the IVC besides new metastatic lymphadenopathy and pulmonary metastasis. Therefore, a multidisciplinary team, which had a crucial role in this complicated case, decided to commence chemotherapy treatment. Such an unusual aggressive metastatic course of LG-ESS is limited in the literature; herein, we recognize a rarely documented disease.
子宫内膜间质肉瘤（ESS）是一种罕见的子宫内膜恶性肿瘤。低级别子宫内膜间质肉瘤（LG-ESS）是ESS侵袭性较低的亚型，很少转移至心脏和大血管。在本研究中，我们报告了一例49岁女性患者，她在6年前治疗了子宫内的初始肿块后出现复发性LG-ESS，有4个月的呼吸困难和易疲劳病史。检查发现右肺栓塞、可疑的右腰大肌肿块和下腔静脉（IVC）大血栓。1个月后，她出现多种胃肠道症状和体重减轻。随后检查显示出现新的右心房肿块、膈下转移性淋巴结病、骶前软组织成分进展、回肠肠袢侵犯、IVC内肿瘤血栓，此外还有新的转移性淋巴结病和肺转移。因此，一个在这个复杂病例中起关键作用的多学科团队决定开始化疗。LG-ESS如此不寻常的侵袭性转移病程在文献中很有限；在此，我们认识到一种记录很少的疾病。
