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      Vaginal Endometrial Stroma Sarcoma: A Case Report of A Rare Disease

      case-report

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          Abstract

          Vaginal endometrial stromal sarcoma (VESS) arising in the vagina is an extremely rare extrauterine endometrial stromal sarcoma, Stroma Sarcoma. To the best of our knowledge, there have been only a few reported cases in the literature. Therefore, we herein report a case of VESS originating in the vagina. A 27-year-old woman complained of heavy and intermittent vaginal bleeding and abdominal swelling all of six months duration. A mass that was firm to hard in consistency was found in the middle and upper segments of the anterior, right lateral, and posterior fornices and wall of the vagina. An excisional biopsy was taken and the immunohistochemistry result revealed VESS. A cystoscopy was done which revealed polypoid metastatic nodules in the bladder (this put the stage of the disease at IV). She also had laparotomy following features of mechanical obstruction from previous pelvic and intraperitoneal adhesions which were formed from previous laparotomy.

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          Endometrial stromal tumors: the new WHO classification.

          Endometrial stromal tumors are rare uterine mesenchymal neoplasms that have intrigued pathologists for years, not only because they commonly pose diagnostic dilemmas, but also because the classification and pathogenesis of these tumors has been widely debated. The current World Health Organization recognizes 4 categories of endometrial stromal tumor: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS). uterine sarcoma. These categories are defined by the presence of distinct translocations as well as tumor morphology and prognosis. Specifically, the JAZF1-SUZ12 (formerly JAZF1-JJAZ1) fusion identifies a large proportion of ESN and LG-ESSs, whereas the YWHAE-FAM22 translocation identifies HG-ESSs. The latter tumors appear to have a prognosis intermediate between LG-ESS and UUS, which exhibits no specific translocation pattern. This review (1) presents the clinicopathologic features of endometrial stromal tumors; (2) discusses their immunophenotype; and (3) highlights the recent advances in molecular genetics which explain their pathogenesis and lend support for a new classification system.
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            Endometrial stromal sarcoma: a systematic review.

            To summarize available studies with respect to evaluation and management of patients with endometrial stromal sarcoma and undifferentiated endometrial sarcoma.
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              Analysis of clinicopathologic prognostic factors for 157 uterine sarcomas and evaluation of a grading score validated for soft tissue sarcoma.

              Uterine sarcomas (US) are rare and carry a poor prognosis characterized by high rates of local recurrence and metastasis. The aim of this study was to test, for what the authors believe was the first time with US, the prognostic impact of the histologic grade validated by the French Federation of Anticancer Centers (FNCLCC) for soft tissue sarcomas (STS). The grade is the sum of the scores allocated for three major histologic criteria: tumor differentiation, mitotic count, and tumor necrosis. Other histologic and clinical factors were tested as well. The study included 157 patients in whom 78 leiomyosarcomas (LMS), 52 malignant mixed müllerian tumors (MMMT), and 27 endometrial stroma sarcomas (ESS) were documented. The median follow-up was 54 months (range, 6-230 months). The median OS and EFS were 33 and 13 months, respectively. The FNCLCC grade validated in soft tissue sarcomas was not a prognostic factor for survival or relapse for any of the US histologic subtypes. For LMS, stage and mitotic count were the only factors that had an influence on survival and relapse. For MMMT, stage and age were the only prognostic factors, and none of the histologic criteria impacted on the outcome. For ESS, the grade defined by Norris and Taylor was an important prognostic factor, particularly for survival. The FNCLCC grading score could not be used as a prognostic indicator for uterine sarcomas. The diagnosis of US is in itself an unfavorable prognostic factor, except when the diagnosis is low grade ESS. Copyright 2000 American Cancer Society.
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                Author and article information

                Journal
                J West Afr Coll Surg
                J West Afr Coll Surg
                JWACS
                Journal of West African College of Surgeons
                Journal of the West African College of Surgeons
                Wolters Kluwer - Medknow (India )
                2276-6944
                2992-5827
                Apr-Jun 2024
                22 February 2024
                : 14
                : 2
                : 233-237
                Affiliations
                [1 ]Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Abuja, Nigeria
                [2 ]College of Health Sciences, University of Abuja, Abuja, Nigeria
                [3 ]Department of Histopathology, University of Abuja Teaching Hospital, Abuja, Nigeria
                Author notes
                Address for correspondence: Dr. Dennis Anthony Isah, Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Abuja 902101, Nigeria. E-mail: dennisanthonyisah@ 123456yahoo.com
                Article
                JWACS-14-233
                10.4103/jwas.jwas_120_23
                10980312
                38562395
                1c61f8f6-438f-4ae7-a6ef-e8b0a86b0bd0
                Copyright: © 2024 Journal of the west African college of surgeons

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 28 June 2023
                : 06 November 2023
                Categories
                Case Report

                endometrial stromal,immunohistochemistry,vaginal sarcoma

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