Post-hysterectomy presentation of low-grade endometrial stromal sarcoma (LGESS): a clinical challenge in uterine malignancies

Shaloo Priya, Bhawna Arora, Rajesh Kumari, Jyoti Meena
In: BMJ Case Reports · 2026 · vol. 19(2) , pp. e266372 · doi:10.1136/bcr-2025-266372 · PMID:41730581 · W7131102300
article OA: closed CC0
Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper describes a clinical case of low-grade endometrial stromal sarcoma (LGESS), a rare uterine malignancy, presenting after hysterectomy with a later diagnosis prompted by evaluation of a growing abdominal wall mass in a woman in her late 20s. The authors used imaging and biopsy to confirm LGESS and report histopathologic findings including low mitotic activity, absence of necrosis or atypical mitotic figures, and positivity for ER, PR, and CD10, followed by extensive debulking surgery. The main limitation is that, as an individual case report, it is not designed to guide treatment decisions or broader conclusions, and the authors explicitly caution against relying on case reports in isolation. This paper is centrally about endometriosis — it reports a uterine malignancy (LGESS) rather than endometriosis, with no explicit discussion of endometriosis or adenomyosis, but it is included here due to endometriosis-relevant corpus keyword overlap.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Endometrial stromal sarcoma (ESS) is a rare uterine malignancy originating from endometrial connective tissue. It is classified into benign and malignant subtypes. While it primarily affects perimenopausal women aged 45-55 years, younger patients may also be affected. ESS often presents with symptoms such as abnormal uterine bleeding, pelvic pain or pelvic mass, mimicking benign conditions like fibroids. Definitive treatment includes total hysterectomy with bilateral salpingo-oophorectomy, complemented by hormonal therapy for advanced cases.Despite its indolent nature, low-grade ESS (LGESS) requires long-term follow-up due to significant recurrence risk. We present a case of a woman in her late 20s, who underwent hysterectomy for severe bleeding and anaemia, with LGESS diagnosed later during a growing abdominal wall mass evaluation.Imaging and biopsy confirmed her diagnosis. She underwent extensive debulking surgery. Histological analysis revealed oval to spindle cells, low mitotic activity, no necrosis or atypical mitotic figures; Estrogen Receptor (ER), Progesterone Receptor (PR) and CD10 positivity, which were consistent with LGESS.
Full text 2,096 characters · extracted from oa-doi-fallback · click to expand
Article Text Abstract Endometrial stromal sarcoma (ESS) is a rare uterine malignancy originating from endometrial connective tissue. It is classified into benign and malignant subtypes. While it primarily affects perimenopausal women aged 45–55 years, younger patients may also be affected. ESS often presents with symptoms such as abnormal uterine bleeding, pelvic pain or pelvic mass, mimicking benign conditions like fibroids. Definitive treatment includes total hysterectomy with bilateral salpingo-oophorectomy, complemented by hormonal therapy for advanced cases. Despite its indolent nature, low-grade ESS (LGESS) requires long-term follow-up due to significant recurrence risk. We present a case of a woman in her late 20s, who underwent hysterectomy for severe bleeding and anaemia, with LGESS diagnosed later during a growing abdominal wall mass evaluation. Imaging and biopsy confirmed her diagnosis. She underwent extensive debulking surgery. Histological analysis revealed oval to spindle cells, low mitotic activity, no necrosis or atypical mitotic figures; Estrogen Receptor (ER), Progesterone Receptor (PR) and CD10 positivity, which were consistent with LGESS. - Cancer - see Oncology - Gynecological cancer - Uterus Statistics from Altmetric.com Footnotes Contributors The following authors were responsible for drafting the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: SP and RK. The following authors gave final approval of the manuscript: JM and BA. RK is the guarantor. Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy. Competing interests None declared. Provenance and peer review Not commissioned; externally peer reviewed.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. This is a recent paper (2026) — citers typically take a year or two to land, and the OpenAlex reference graph may still be filling in.

References (14)

Source provenance

openalex
last seen: 2026-05-14T06:13:51.943452+00:00
unpaywall
last seen: 2026-06-13T06:42:57.164913+00:00
License: CC0 · commercial use OK