Mesenchymal tumors of the uterus. I. A clinical and pathological study of 53 endometrial stromal tumors

TLDR

The study examined 53 endometrial stromal tumors to identify pathological features linked to clinical behavior. Tumors were morphologically divided into benign stromal nodules with pushing margins and infiltrating lesions (endolymphatic stromal myosis or stromal sarcoma), the latter further classified by mitotic activity. Patients with endolymphatic stromal myosis survived 100 % at five years, those with stromal sarcoma 55 %; tumor size and venous invasion showed a modest prognostic correlation, atypia did not, radiotherapy benefited patients with uncontrolled, symptomatic extra‑uterine disease, and clinical presentation was indistinguishable from other uterine tumors.

Abstract

The clinical and pathologic features of 53 endometrical stromal tumors were studied to determine which pathologic characteristics were related to the clinical behavior. Morphologically, stromal tumors were divided into 2 groups: 18 tumors with pushing margins (stromal nodules) and 35 tumors with infiltrating margins (endolymphatic stromal myosis or stromal sarcoma). Stromal nodules, which were expansile, noninfiltrating lesions composed of cells similar to those found in normal endometrial stroma, were considered benign. The tumors with infiltrating margins were separated on the basis of mitotic activity. Patients with endolymphatic stromal myosis had 100% survival at 5 years and those with stromal sarcoma had 55% survival. The size of the primary tumor and presence of vein invasion showed a slight correlation with the patient's prognosis but no correlation was found with increasing degrees of cellular atypism. For patients whose disease was not controlled by hysterectomy and who had symptomatic extra-uterine tumor, x-ray irradiation appeared to be of benefit. The patients' symptoms and physical examination findings were not different from those of patients having other uterine tumors.