JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. X, n 1, June 2023

Pages: 1214-1218
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A p16 positive pleomorphic Endometrial Stromal Sarcoma: An Unusual Case Scenario

Author: Sarika Gupta, Anshul Singh, Vatsala Misra

Category: JMSR Pathology

Abstract:

Endometrial stromal sarcomas are rare uterine malignancies, particularly in young women,and are divided into four types- Endometrial Stromal Nodules [ESN], Low Grade ESS [LGESS], High Grade ESS [HGESS] and Undifferentiated Uterine Sarcomas [UUS]. A fifth category of Endometrial Stromal Sarcomas – Not Otherwise Specified [ESS-NOS] has also been kept for tumours with a predominantly high grade morphology showing significant LG ESS areas as well. Herein, we report a case of a 26 year old woman who presented with an abdominal mass and bleeding per vaginum. Abdomino pelvic ultrasound revealed a neoplastic polypoidal lesion. Post hysterectomy, histopathological examination revealed a tumour mass with features of a highly pleomorphic high grade endometrial stromal sarcoma[HGESS] along with concomitant features of low grade endometrial stromal sarcoma[LGESS] as well. Application of IHC panel further revealed that the tumorcame out to be immuno reactive for vimentin, cyclin D1, INI1 and p-16 with focal positivity for Calretinin, Glypican 3 and CD99, the demonstration of p16 positivity being highly unusual for a HGESS. As the patient’s condition deteriorated rapidly and she expired soon after the initial examination started, molecular profiling could not be done

Keywords: p16 positive, Endometrial sarcomas, stromal neoplasms of uterus, high grade endometrial stromal sarcomas, undifferentiated endometrial sarcomas

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