Long-term disease-free survival after bilateral video-assisted thoracoscopic resection of multiple pulmonary metastases from endometrial stromal sarcoma: An 8-year follow-up case report

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-09-11 DOI:10.1016/j.gore.2025.101954

Eitetsu Koh , Yasuo Sekine , Tadao Nakazawa , Kenzo Hiroshima

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Abstract

Background

Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy prone to late recurrence and distant metastasis, most commonly to the lungs. Bilateral multiple pulmonary metastases are exceedingly uncommon, and optimal management remains unclear.

Case presentation

A 51-year-old woman underwent total abdominal hysterectomy for LG-ESS at age 43. Eight years later, routine chest radiography revealed multiple bilateral pulmonary nodules. Computed tomography showed three well-circumscribed nodules (7–9 mm) in the left S4, left S8, and right S8 segments. Positron emission tomography showed minimal fluorodeoxyglucose uptake. Bilateral video-assisted thoracoscopic wedge resections were performed, achieving complete removal of all lesions. Histopathology confirmed metastatic LG-ESS (CD10/ER/PR positive). The patient received oral medroxyprogesterone acetate for five years. The therapy was discontinued following subarachnoid hemorrhage due to a ruptured posterior-circulation intracranial aneurysm and treated by surgical clipping; she has no residual neurological deficits. She remains disease-free a total of eight years after metastasectomy.

Conclusion

Complete resection of bilateral multiple pulmonary metastases from LG-ESS, combined with hormonal therapy, can achieve durable long-term disease control in carefully selected patients.

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双侧胸腔镜切除子宫内膜间质肉瘤多发肺转移瘤后的长期无病生存：8年随访病例报告

背景：低级别子宫内膜间质肉瘤（LG-ESS）是一种罕见的晚期复发和远处转移的子宫恶性肿瘤，最常见于肺部。双侧多发肺转移非常罕见，最佳治疗方法尚不清楚。一例51岁女性在43岁时接受了全腹部子宫切除术。8年后，常规胸片显示双侧多发肺结节。计算机断层扫描显示左侧S4，左侧S8和右侧S8节段三个界限清晰的结节（7 - 9mm）。正电子发射断层扫描显示微量的氟脱氧葡萄糖摄取。进行双侧胸腔镜楔形切除，完全切除所有病变。组织病理学证实转移性LG-ESS （CD10/ER/PR阳性）。患者口服醋酸甲孕酮5年。由于颅内后循环动脉瘤破裂导致蛛网膜下腔出血，并通过手术夹持治疗，该治疗停止；她没有残留的神经缺陷。她在转移瘤切除术后的八年里一直没有患病。结论经精心挑选的患者，完全切除双侧多发性肺转移灶，结合激素治疗，可实现持久、长期的疾病控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.