{"paper_id":"b40ee31e-0346-4bc0-a802-6b6eea319c3e","body_text":"Abstract\nEndometrial stromal sarcoma is an uncommon gynecological tumor. Extra-uterine endometrial stromal sarcoma (EESS), the extra-uterine variant of its relatively more common counterpart, is even rarer with only few documented case reports. We report a case of a 40-year woman with bilateral adnexal tumors and synchronous invasive ductal breast carcinoma (IDC) posing a diagnostic challenge. The histopathology of specimen confirmed the diagnosis of EESS in the absence of florid endometriosis and synchronous hormone-positive infiltrating duct cancer in the breast. Patient was started on adjuvant endocrine therapy and is disease free at the end of 2 years. To the best of our knowledge, this is the first documentation of synchronous presentation of IDC and EESS, highlighting the possible role of hyper-estrogenemia as an etiological factor.\nReferences\nMasand RP, Euscher ED, Deavers MT, et al. Endometrioid stromal sarcoma. Am J Surg Pathol. 2013;37(11):1635–47. https://doi.org/10.1097/PAS.0000000000000083.\nTian W, Latour M, Epstein JI. Endometrial stromal sarcoma involving the urinary bladder: a study of 6 cases. Am J Surg Pathol. 2014;38(7):982–9. https://doi.org/10.1097/PAS.0000000000000214.\nOliva E, Egger JF, Young RH. A clinicopathologic study of 27 cases with morphologic and behavioral features similar to those of uterine low-grade endometrial stromal sarcoma. Am J Surg Pathol. 2014;38(3):305–15. https://doi.org/10.1097/PAS.0000000000000145.\nAltman AD, Nelson GS, Chu P, et al. Uterine sarcoma and aromatase inhibitors: Tom Baker cancer centre experience and review of the literature. Int J Gynecol Cancer. 2012;22(6):1006–12. https://doi.org/10.1097/IGC.0b013e31825b7de8.\nFunding\nNo funding or financial support was received from any commercial organization. Authors declare no conflicts of interest with anybody\nAuthor information\nAuthors and Affiliations\nCorresponding author\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nDr. Pavneet Kohli is an Assistant professor, Department of Surgical Oncology, JIPMER, Puducherry, India; Dr. Prasanth Penumadu is an Associate professor, Department of Surgical Oncology, JIPMER, Puducherry, India; Dr. Neelesh Srivastava is a senior resident, Department of Surgical Oncology, JIPMER, Puducherry, India; Dr. Bheemanathi Hanuman Srinivas is an Additional Professor, Department of Pathology, JIPMER, Puducherry, India; Dr. Vidyalakshmi Rangarajan is a senior resident, Department of Pathology, JIPMER, Puducherry, India.\nRights and permissions\nAbout this article\nCite this article\nKohli, P., Penumadu, P., Srivastava, N. et al. Primary Extra-Uterine Endometrial Stromal Sarcoma and Synchronous Breast Cancer: A Double Whammy: A Case report. J Obstet Gynecol India 71, 326–329 (2021). https://doi.org/10.1007/s13224-021-01437-6\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s13224-021-01437-6","source_license":"CC0","license_restricted":false}