Introduction
Endometrial stromal sarcomas (ESS) are difficult to diagnose, both due to the rarity of the tumor and because of the close resemblance of the tumor to normal stromal tissue. The most common extra-uterine site of ESS is the ovary. We report a case of, huge primary low-grade endometrial stromal sarcoma in the ovary, infiltrating bladder and right ureter.
Case Report
A 40-year-old lady presented with lower abdominal pain and fullness. On radiological examination, a huge abdomino-pelvic mass, with solid and cystic areas, with right hydroureteronephrosis was found.
Discussion
ESS pose a diagnostic challenge at extra-uterine sites. Malignant mixed mullerian tumor and sex cord stromal tumor are the close differential diagnoses. The other issue is deciding whether the tumor is primary or secondary in origin, especially in a previously hysterectomised patients. Various treatment options such as hormonal therapy, chemotherapy and radiotherapy exist but are not beneficial owing to the slow-growing nature of the tumors.
Conclusion
Primary ovarian ESS is a possibility after excluding possible metastatic spread from uterine ESS.