Transition of endometrial stromal sarcoma into high-grade sarcoma
Transition of endometrial stromal sarcoma into high-grade sarcoma
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DOI：
10.1016/j.ygyno.2006.07.013
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发表时间：
2006-12-01
影响因子：
4.7
通讯作者：
Vergote, Ignace
中科院分区：
文献类型：
--
作者：
Amant, Frederic;Woestenborghs, Heidi;Vergote, Ignace
背景子宫内膜间质肉瘤通常为低度恶性且对化疗敏感。虽然这些特征导致了懒惰的行为，但随着时间的推移，几乎没有关于进化的数据。我们报告的两个案例中，显微镜和肿瘤的生化评估在几个场合在8年和25年的后续行动，使我们能够记录一个过渡的低级别到高级别的恶性肿瘤。其主要特征是细胞增殖增加，螺旋小动脉缺失，有丝分裂指数和增殖指数（MIB1）增加。由于这一转变与临床激素敏感性丧失有关，因此由激素治疗联合重复手术组成的治疗方法改为仅化疗。这些长期随访数据提供了对子宫内膜肉瘤肿瘤生物学的深入了解，并强调了对复发肿瘤进行采样以估计生物学行为的重要性，以便定制后续治疗。(c)2006年爱思唯尔公司All rights reserved.
Background. Endometrial stromal sarcoma typically is of low grade and hormone-sensitive. Although these characteristics result in an indolent behavior, little data are available on the evolution over time.Case. We report on two cases where microscopic and immunohistochemic assessment of the tumor on several occasions during 8 and 25 years of follow up enabled us to document a transition of a low-grade into a high-grade malignancy. These were mainly characterized by increased cellular atypia, absence of spiral arterioles and an increased mitotic index and proliferation index (MIB1). Since this transition was related to clinical loss of hormone sensitivity, the therapeutic approach consisting of hormonal treatment in combination with repetitive surgery was switched to chemotherapy only.Conclusion. These long-term follow up data provide insight in endometrial strornal sarcoma tumor biology and highlight the importance of sampling recurrent tumors to estimate biologic behavior in order to tailor subsequent treatment. (c) 2006 Elsevier Inc. All rights reserved.