Khattak Aruba Nawaz, Shahab Aymen, Israr Fatima, Yaqub Hira, Sheikh Zulfiqar, Siddique Kashif
Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
Radiol Case Rep. 2025 May 21;20(8):3911-3917. doi: 10.1016/j.radcr.2025.04.100. eCollection 2025 Aug.
Histiocytic uterine sarcoma is an extremely rare tumor with aggressive clinical course characterized by the proliferation of histiocytic cells. It is a challenging entity in terms of both diagnosis and therapy. On imaging, it has nonspecific features and a broad range of differentials, depending on regional involvement. Definitive diagnosis often requires a combined approach using microscopic and pathologic analysis in conjunction with an immunohistochemical stains. We present the case of a 65 year old getting diagnosed as a case of endometrial histiocytic sarcoma developing progressive disease over the course of 1 year despite having undergone surgical resection followed by radiation therapy. The pattern of metastatic involvement down the course of her disase is unique in its presentation as a solitary paraspinal mass with no imaging evidence of visceral metastasis. Though uterine sarcomas can metastasize to unusual sites, paraspinal metastasis is almost unprecedented, emphasizing the need for thorough imaging and surveillance. With this report, we not only aim to highlight a rare metastatic presentation of uterine histiocytic sarcoma, but also to give an insight into the clinical features, diagnostic workup, and treatment challenges.
组织细胞性子宫肉瘤是一种极其罕见的肿瘤，临床病程具有侵袭性，其特征为组织细胞的增殖。在诊断和治疗方面，它都是一个具有挑战性的疾病实体。在影像学上，根据受累部位不同，它具有非特异性特征和广泛的鉴别诊断范围。明确诊断通常需要结合显微镜检查、病理分析以及免疫组化染色的综合方法。我们报告了一例65岁女性患者，被诊断为子宫内膜组织细胞肉瘤，尽管接受了手术切除及放疗，但在1年的病程中仍出现了疾病进展。其疾病过程中的转移受累模式独特，表现为孤立的椎旁肿块，影像学检查未发现内脏转移证据。虽然子宫肉瘤可转移至不常见部位，但椎旁转移几乎前所未闻，这凸显了全面影像学检查和监测的必要性。通过本报告，我们不仅旨在强调子宫组织细胞肉瘤罕见的转移表现，还希望深入了解其临床特征、诊断检查及治疗挑战。
