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Sarcoma de estroma endometrial. Estudio clinicopatológico e inmunofenotípico de 5 casos

Departamento de Anatomía Patológica, Hospital Clínico Universitario de Valencia
SORIANO SARRIO, Pilar ; Martinez Rodriguez, Miguel ; Soriano, Diego ; Llombart Bosch, Antonio ; Navarro Fos, Samuel ; 2007, Sarcoma de estroma endometrial. Estudio clinicopatológico e inmunofenotípico de 5 casos, Revista Española de Patología, vol 40. no. 1. p. 40-45 01/2007; DOI: 10.1016/S1699-8855(07)70054-5
Source: OAI

ABSTRACT Introducción: El sarcoma de estroma endometrial uterino es un tumor muy poco frecuente con una incidencia de 0,4 -3,4 por 100.000 mujeres, comprende menos del 1% de tumores malignos ginecológicos y el 2-5% de tumores malignos uterinos, siendo el tercer sarcoma en frecuencia después del carcinosarcoma y el leiomiosarcoma. Material y métodos: Presentamos cinco casos de sarcoma de estroma endometrial diagnosticados en un periodo de siete años con la evolución clínica de las pacientes. Resultados: Immunohistoquímicamente, estos tumores expresaban vimentina, receptores hormonales, CD10 y p53 (sarcomas de alto grado), siendo los marcadores musculares, la CK, el c-kit y ALK negativos. De estos cinco sarcomas dos de ellos eran de alto grado y tres de bajo grado (uno con diferenciación miogénica y otro combinado con áreas tipo «cordones sexuales», áreas miogénicas y áreas estromales puras). Discusión: Asimismo se plantean una serie de diagnósticos diferenciales con metodología práctica para poder caracterizar estos tumores. Introduction: Endometrial stromal sarcoma (ESS) is an infrequent neoplasm with an incidence of 0,4-3,4 cases/100.000 woman. This tumor represents less than 1% of the gynecologic malignancies as well as the 2,5% of the uterine malignant tumors being the third malignancy after carcinosarcoma and leiomyosarcoma. Patients and methods: We present five cases of endometrial sarcoma, diagnosed in a period of seven years. This study includes a complete immunohistochemical analysis as well as the follow-up of the patients. Results: Immunohistochemically, these tumors expressed vimentin, hormone receptors, CD10 and p53 (high grade sarcomas), whereas muscle markers, CK, c-Kit and ALK resulted negative. Two of the ESS were high grade tumors whereas the other three were considered low grade tumors (one with myogenic differentiation and the other combining sex cord areas, myogenic foci and pure stromal areas). Discussion: We discuss their differential diagnosis with other uterine malignant tumors. Martinez Rodriguez, Miguel, Miguel.Martinez-Rodriguez@uv.es ; Llombart Bosch, Antonio, Antonio.Llombart@uv.es ; Navarro Fos, Samuel, Samuel.Navarro@uv.es

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