Endometrial stromal tumour

Endometrial Stromal Tumour (EST) is a rare type of uterine cancer that originates from the connective tissue (stroma) of the endometrium, the lining of the uterus. These tumors are part of a spectrum of neoplasms that range from benign to malignant, including endometrial stromal nodules, low-grade endometrial stromal sarcomas, and high-grade endometrial stromal sarcomas. Understanding the characteristics, diagnosis, treatment, and prognosis of endometrial stromal tumors is crucial for effective management and patient care.

Classification[edit | edit source]

Endometrial stromal tumors are classified based on their behavior and histological characteristics:

Endometrial Stromal Nodules are benign tumors that do not invade the myometrium.
Low-grade Endometrial Stromal Sarcomas (LGESS) are malignant tumors characterized by slow growth and a tendency to recur locally.
High-grade Endometrial Stromal Sarcomas (HGESS) are aggressive tumors that exhibit rapid growth and a high potential for metastasis.

Symptoms[edit | edit source]

Symptoms of endometrial stromal tumors may vary depending on the size and location of the tumor. Common symptoms include:

Abnormal uterine bleeding
Pelvic pain or pressure
An enlarged uterus
Frequent urination or difficulty emptying the bladder

Diagnosis[edit | edit source]

Diagnosis of endometrial stromal tumors involves a combination of clinical evaluation, imaging studies, and histopathological examination. Key diagnostic tools include:

Ultrasound: To assess the uterus and identify any abnormal growths.
Magnetic Resonance Imaging (MRI): To provide detailed images of the uterus and help differentiate ESTs from other types of uterine tumors.
Biopsy: A sample of the tumor is examined under a microscope to confirm the diagnosis and determine the grade of the tumor.

Treatment[edit | edit source]

Treatment options for endometrial stromal tumors depend on the type and stage of the tumor, as well as the patient's overall health and preferences. Treatment strategies may include:

Surgery: The primary treatment for ESTs, often involving a hysterectomy with or without removal of the ovaries and fallopian tubes.
Hormone Therapy: May be used for low-grade tumors to slow tumor growth.
Radiation Therapy: Occasionally used to treat residual disease or recurrences.
Chemotherapy: Typically reserved for high-grade tumors or metastatic disease.

Prognosis[edit | edit source]

The prognosis for patients with endometrial stromal tumors varies based on the type and stage of the tumor at diagnosis. Low-grade tumors generally have a favorable prognosis with a high 5-year survival rate, while high-grade tumors are associated with a poorer prognosis due to their aggressive nature and potential for metastasis.

Epidemiology[edit | edit source]

Endometrial stromal tumors are rare, accounting for less than 10% of all uterine sarcomas. They most commonly occur in perimenopausal and postmenopausal women, but can also affect women of reproductive age.