A middle-aged woman had a pelvic mass that demonstrated the classical histopathologic features of low-grade endometrial stromal sarcoma. The clinical history revealed that she had undergone hysterectomy 10 years previously, allegedly for uterine leiomyomas, but neither the slides nor the paraffin blocks (both at another hospital) were available for review. This is, unfortunately, one of the frequent presentations of this uncommon tumor, and it has resulted in malpractice actions against pathologists with a frequency out of proportion to the prevalence of the tumor itself. This report emphasizes the differential diagnosis, with particular emphasis on the pitfalls for the unwary pathologist.
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Steven G. Silverberg (2000) studied this question.