Endometrial stromal tumors

Last revised by Andrew Murphy on 18 Feb 2018

Endometrial stromal tumors (EST) are an uncommon group of tumors arising from endometrial stromal cells. It accounts for <2% of all uterine malignancies and 10% of all uterine sarcomas.

Half occur in premenopausal women, with most patients presenting in the 5th decade.

The symptoms are non specific and include menorrhagia, abdominal pain or a palpable pelvic mass.

Over the past four decades, EST classification has gone through various modifications starting from the earliest study by Norris and Taylor. This was primarily due to the rarity of the tumors. With better understanding, and at the time of writing (mid 2016), the 2014 WHO classification has replaced the broad categories of the 2003 WHO classification following incorporation of molecular findings.

Lesions can be of mixed echotexture 3.

Features reported to be more prevalent in EST include 1:

  • irregular margin(s)
  • nodular lesions at the margin(s)
  • intra-myometrial nodular extension
  • multiple nodular mass formation
  • tumor extension along the vessels or ligaments (considered characteristic 5
  • T2: may show bands of low signal (representing preserved bundles of myometrium) within the areas of myometrial involvement  

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