High-Grade Endometrial Stromal Sarcoma

Humairah Medina Liza Lubis

Abstract


High-Grade Endometrial Stromal Sarcoma

Abstrak: High-grade endometrial stromal sarcoma merupakan tumor yang agresif dan pada kebanyakan kasus, kematian sering terjadi tiga tahun setelah histerektomi.Ditandai dengan ketiadaan diferensiasi spesifik dan gambaran histologis yang tidak menyerupai stroma endometrium. Insidensinya diperkirakan sekitar 10% dari keseluruhan tumor mesenkim uterus dan hanya 0,2% dari seluruh keganasan uterus. Sering ditemukan pada korpus uterustetapi dapat meluas ke ekstrauterus.Umumnya keluhan berupa perdarahan pervaginam, nyeri panggul dan pada pemeriksaan fisik terkadang menunjukkan pembesaran uterus atau penonjolan tumor melewati cervical os. Kami melaporkan satu kasus yang ditemukan di praktek swasta dokter spesialis Patologi Anatomi dan RSUP H. Adam Malik Medan pada seorang wanita berumur 27 tahun dengan keluhan perdarahan pervaginam sejak 6 tahun yang lalu. Dilakukan STAH dan BSO di rumah sakit daerah dan beberapa bulan kemudian dilakukan biopsi serviks. Pemeriksaan histopatologi pada endometrium dan serviks didapatkan gambaran yang sama berupa komponen sarcomatous yang diduga berasal dari stroma endometrium. Imunohistokimia menggunakan marker S-100 protein, Vimentin, Desmin, SMA dan CD10, dengan komponen mesenkim yang positif pada Vimentin, Desmin dan SMA, sedangkan komponen epitelial negatif dengan S-100 protein. Kemudian untuk membedakannya dengan limfoma Non Hodgkin dipakai marker CD10 dengan hasil negatif.Sehingga dapat disimpulkan sebagai kasus High-Grade Endometrial Stromal Sarcoma pada endometrium dan serviks.

Kata kunci: high-grade endometrial stromal sarcoma, low-grade endometrial stromal sarcoma, stroma endometrium, imunohistokimia.

 

High-Grade Endometrial Stromal Sarcoma

 Abstract: High-grade endometrial stromal sarcoma is an aggressive tumor, and death occurs from tumor dissemination within three years after hysterectomy in most cases. A high grade endometrial sarcoma that lacks specific differentiation and bears no histological resemblance to endometrial sarcoma. Represent approximately10% of all uterine mesenchymal tumors. Most occurs in corpus uterine and adjacent to extra uterine. The patient had vaginal bleeding, pelvic pain and on physical examination findings uterine enlargement throughout cervical os. We report an unusual case of ESS arising in a-27-year-old woman had vaginal bleeding since 6 years previously. She had undergone subtotal hysterectomy and bisalphyngoovorectomy previously and a few months ago had cervical biopsy. On histological findings, sarcomatous component was suspectly endometrial stromal origin. Immunostaining showed that mesenchymal component were vimentin, desmin, and SMA-positive, whereas epithelial component were S-100 protein-negative. Distinction ESS from Non Hodgkin lymphoma was usedCD10 antigen, and the result was stained negative for CD10. The conclusion for this case was High-Grade endometrial stromal sarcoma on endometrial and cervical uterine.

Keywords: High-Grade Endometrial Stromal Sarcoma, Low-Grade Endometrial Stromal Sarcoma, endometrial stromal, imunohistochemistry


Full Text:

PDF

References


Tavassoli AF, Devilee P. Pathology and Genetics. Tumours of the Breast and Female Genital Organs. World Health Organization Classification of Tumours. International Agency for research on Cancer. IARC Press. Lyon. 2003 : 233-6.

Berek SJ. Novak’s gynecology. 13th ed. Lippincott Williams and Wilkins. 2002. p. 1179-81.

McCluggage WG, Ganesan R, Herrington S. Endometrial stromal sarcomas with extensive endometrioid glandular differentiation: report of a series with emphasis on the potential for misdiagnosis and discussion of the differential diagnosis. Histopathology. 2009; 54: 365–373. DOI: 10.1111/j.1365-2559.2009.03230.

Aubry Marie-Christine, Myers LJ, Colby VT, Leslie OK, Tazelaar DH. Endometrial stromal sarcoma metastatic to the lung. A Detailed Analysis of 16 Patients. Lippincott Williams &Wilkins, Inc, Philadelphia. The American Journal of Surgical Pathology. 2002, 26(4): 440–449.

Feng D. Endometrial stromal sarcoma of the uterus with arterial tumor embolus. The Internet Journal of Gynecology and Obstetric. ISSN: 1528-8439.

Kumar, Abbas: Robbins and cotran pathologic basis of disease. 7th ed. Elsevier: 2005.

Ronnett BM, Zaino RJ, Elleson LH, Kurman RJ. Endometrial carcinoma.

Blaustein’s Pathology of the Female Genital Tract. 5th ed. Springer; 2002 : 538-41.

Kim YW, Lee WJ, Choi HC, Kang H, Kim JT, Kim GB, Lee HJ, Bae DS. Low-grade endometrial stromal sarcoma: a single center’s experience with 22 cases. Int J Gynecol Cancer 2008, 18, 1084–1089.

Dabbs D. Diagnostic immunohistochemistry. 2nd ed. Elsevier. Churchill Livingstone. 2006.

Abeler MV, Røyne O, Thoresen S, Danielsen EH, Nesland NJ, KristensenBG. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology 2009, 54, 355–364. DOI: 10.1111/j.1365-2559.2009.03231.


Refbacks

  • There are currently no refbacks.


Flag Counter

Sekretariat:

Gedung Kampus 1 UMSU Lantai II,Laboratorium Farmakologi dan Terapi FK UMSU-Jalan Gedung Arca No. 53 Medan-Sumatera Utara , Kode Pos 20217 Kontak: 0812-6208-2844, E-mail: buletinfarmatera@gmail.com

Indexed by: