Uterine tumor resembling ovarian sex cord tumor: A series of six cases displaying varied histopathological patterns and clinical profiles

Indian J Pathol Microbiol. 2020 Feb;63(Supplement):S81-S86. doi: 10.4103/IJPM.IJPM_340_19.

Abstract

Introduction: Uterine tumors resembling ovarian sex cord tumor (UTROSCT) are a unique group of neoplasms with diverse morphology and immunophenotypic characteristics, coexpressing sex cord, epithelial, and smooth-muscle markers. To date, less than 100 cases have been reported and there is paucity of data concerning their clinical behavior.

Materials and methods: All cases of uterine body tumors diagnosed over a period of two and a half years (2016-2018) were retrieved. Histopathological features were reviewed and extended panel of immunohistochemistry was performed to identify cases of UTROSCTs.

Results: Six cases of UTROSCTs were identified with a median age of 46.5 years. Four of them presented with menorrhagia, while two with postmenopausal bleeding including one with a history of carcinoma breast. Three of these cases were initially misdiagnosed as endometrial stromal sarcoma and adenocarcinomas. They all underwent hysterectomy with bilateral salpingo-oophorectomy.

Conclusion: It is considered a tumor with low malignant potential; however, one out of six cases (16.7%) in our study showed metastasis, within 1 year of diagnosis. It is important to recognize this entity as it mimics a wide range of both benign and malignant tumors. Molecular pathogenesis and exact management protocols remain elusive due to rarity,hence, multi-institutional studies are warranted.

Keywords: Mesenchymal neoplasm; ovarian; sex cord stromal; uterus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biomarkers, Tumor
  • Diagnosis, Differential
  • Diagnostic Errors
  • Endometrial Neoplasms / diagnosis
  • Female
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / pathology
  • Ovary / pathology
  • Sarcoma, Endometrial Stromal / diagnosis
  • Sex Cord-Gonadal Stromal Tumors / diagnosis*
  • Sex Cord-Gonadal Stromal Tumors / pathology
  • Uterine Neoplasms / diagnosis*
  • Uterine Neoplasms / pathology*

Substances

  • Biomarkers, Tumor