Key result
Palliative chemotherapy chosen over surgery for rare endometrial sarcoma metastasis to the IVC and right atrium.
Why the study?
Low-grade endometrial stromal sarcoma rarely metastasizes to the heart and large blood vessels, with an unusually aggressive metastatic course limited in the literature.
Case Report (n=1)
This case report documents a rare instance of low-grade endometrial stromal sarcoma metastasizing to the inferior vena cava and right atrium.
May support individualized palliative chemotherapy in rare extensive cardiac metastases from endometrial stromal sarcoma; leaves open optimal management strategy.
Endometrial stromal sarcoma (ESS) is a rare, malignant tumor of the endometrium. Low-grade endometrial stromal sarcoma (LG-ESS) is a less aggressive subtype of ESS that rarely metastasizes to the heart and large blood vessels. In the present study, we report a case of recurrent LG-ESS after treating the initial mass in the uterus six years ago in a 49-year-old female who presented with a four-month history of dyspnea and easy fatigability. Investigations revealed a right pulmonary embolism, suspicious right psoas muscle mass, and a large inferior vena cava (IVC) thrombus. One month later, she presented with multiple gastrointestinal symptoms and weight loss. Investigations then showed the development of a new right atrial mass, infra-diaphragmatic metastatic lymphadenopathy, progression of the presacral soft tissue component, invasion of the ileal bowel loop, and a tumoral thrombus in the IVC besides new metastatic lymphadenopathy and pulmonary metastasis. Therefore, a multidisciplinary team, which had a crucial role in this complicated case, decided to commence chemotherapy treatment. Such an unusual aggressive metastatic course of LG-ESS is limited in the literature; herein, we recognize a rarely documented disease.
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Alswiket et al. (2022) conducted a case report in Low-Grade Endometrial Stromal Sarcoma (n=1). Chemotherapy (gemcitabine/docetaxel) and enoxaparin was evaluated. In a rare case of recurrent low-grade endometrial stromal sarcoma with extensive metastasis to the inferior vena cava and right atrium, palliative chemotherapy was chosen over surgical resection.
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