Endometrial Stromal Sarcoma: An Unusual Bone Metastasis in the Proximal Humerus

María Martínez García, Matías Antonio Miniño Méndez, David Segura Sánchez and Antonio Silvestre Muñoz

Department of Surgery, University of Valencia, Spain

^*Correspondance to: Mar�a Mart�nez Garc�a 

 PDF  Full Text DOI: 10.25107/2474-1647.2045

Abstract

Myeloma, breast, prostate and lung cancer, are related to most of skeletal lesions in people over 40 years of age, specially at axial skeleton. According to the American Cancer Society, bone metastases are more common than primary bone tumours. Endometrial Stromal Sarcoma (ESS) is a rare tumour (less than 10% of uterine sarcomas and 0.25% of all malignant uterine tumours), affecting women with an average age of 45 years. This disease has a slow clinical development, being classified in low or high grade depending on its behaviour. Treatment is hysterectomy combined with adjuvant radiotherapy to reduce the number of recurrences in the most aggressive types; several authors agree that radiotherapy decreases relapses but does not have a significant impact on survival rate, as well as hormone therapy. Many reported cases describe the appearance of secondary metastases of endometrial stromal sarcoma mainly at the belly (guts), pelvis and lung. Bone metastases are rare and the few cases reported refer to metastasis that take place in the axial skeleton (dorsal and lumbar vertebrae, sacrum, and iliac bones).A woman of 40 years old with a lytic bone lesion at the left proximal humerus came to the office; the lesion was diagnosed by an open biopsy in another Institution. The outcome of this biopsy was a primary humerus tumour (myxofibrosarcoma), but final diagnosis after resection of the whole tumour was bone metastasis of endometrial stromal sarcoma. The purpose of this clinical case is to highlight the possible, although uncommon, involvement of bone tissue by endometrial stromal sarcoma, even in young patients. Therefore we would like to draw attention to complexity of diagnosis of this disease that at first glance was interpreted as a primary bone disease

Keywords

Cite the article

Garc�a MM, M�ndez MAM, S�nchez DS, Mu�oz AS. Endometrial Stromal Sarcoma: An Unusual Bone Metastasis in the Proximal Humerus. Clin Surg. 2018; 3: 2045.