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Endometrial stromal sarcoma-recurrence

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Status post total abdominal hysterectomy and bilateral salpingo-oophorectomy 6 months ago. Referred for follow up pelvic MRI.

Patient Data

Age: 55 years
Gender: Female

Uterus and ovaries are not seen.

There is 55*60*75 mm heterogenous signal enhancing mass with necrotic center and areas of water restriction at col du sac space.

Adhesion of the mass to mesorectal fascia and rectosigmoid loops is present.

Case Discussion

Microscopic diagnosis:  The patient histopathologic diagnosis of uterine mass after total abdominal hysterectomy and bilateral salpingo-oophorectomy six months ago was high-grade endometrial stromal sarcoma.

Regarding the imaging findings and histopathologic results, the recurrence of the known aggressive pelvic mass was the final diagnosis.

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