A Case Report of a Severely Aggressive Uterine Sarcoma at an Unusual Age

Uterine sarcomas are very unique tumors with mesodermial origin and accounting for 2-6% of uterine cancers. In general, uterine sarcomas are the most malignant tumors of the uterus. Their usual histologic types are endometrial estromal sarcoma, lieomyosarcoma and malignant mixed mullerian tumor or carcinosarcoma In this case report, a 19 year old woman with chief complaint of abnormal uterine bleeding from 1 year ago is presented. The patient had 3 times curettage in this period and due to the last pathology report that was suspicious for uterine sarcoma referred to Afzali Poor Hospital. In the last sonography, a huge pelvic mass was reported with hydronephrosis and dilated left ureter. Furthermore, in the last CT scan a suspicious mass in favor of leiomyoma was reported too. In laparotomy surgery due to frozen section report of fibro sarcoma, hysterectomy and bilateral salpigo oophorectomy was done. In final pathology, endometrial stromal sarcoma was reported.  Endometrial stromal sarcoma accounts for 15% of uterine sarcomas usually seen in perimenopausal period. The usual symptom of this tumor is abnormal uterine bleeding. Some of these patients are asymptomatic. The main therapy of these patients is total hysterectomy and bilateral salpingo oophorecomy.