Cerebral metastases of an endometrial stromal sarcoma: report of the first case.

BACKGROUND

Endometrial stromal sarcomas (ESSs) of the uterus are rare gynecological malignancies. Common locations of distant metastases are vagina, vulva, lung, mediastinum, abdomen, bones and ovaries.

METHODS

We present the case of a 69-year-old woman with a Federation of Gynecology and Obstetrics (FIGO) IIb (classification 2009) ESS of the uterus of high-grade malignancy. Initially, a hysterectomy Piver II and total colpectomy were performed, followed by pelvic field irradiation. 8 months later, the patient suffered seizures and hemiparesis. A computed tomography (CT) scan revealed cerebral metastases, and irradiation of the brain was initiated. After completion of the staging examinations, additional metastases of lung, abdomen, mediastinum, vulva and inguinal lymph nodes were found. This is the first reported case of brain metastases of an ESS.

CONCLUSIONS

Appropriate treatment options like surgery, chemotherapy or endocrine therapy should be discussed on an individual basis since large-scale clinical trials have not yet been conducted in this rare entity.