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

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

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

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

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

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

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.

See Also

• Uterine cancer
• Sarcoma
• Hysterectomy
• Hormone therapy