Development of endometrial stromal sarcoma in a patient undergoing in vitro fertilization: A case report

•A new endometrial lesion during IVF may represent an endometrial stromal sarcoma.•Diagnosis of ESS requires full histologic inspection of tumor-myometrial interface.•Main treatment of ESS is total hysterectomy and bilateral salpingo-oophorectomy.•Fertility sparing management of low-grade ESS can be...

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Bibliographic Details
Published in:Gynecologic oncology reports 2020-05, Vol.32, p.100541, Article 100541
Main Authors: Patel, Tulsi, Sosa-Stanley, Jessica N., Evans-Hoeker, Emily, Osborne, Janet L.
Format: Article
Language:English
Subjects:
Case Report
Endometrial stromal sarcoma
Hormonal treatment
In vitro fertilization
Infertility
Uterus
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Summary:•A new endometrial lesion during IVF may represent an endometrial stromal sarcoma.•Diagnosis of ESS requires full histologic inspection of tumor-myometrial interface.•Main treatment of ESS is total hysterectomy and bilateral salpingo-oophorectomy.•Fertility sparing management of low-grade ESS can be considered in young patients. Development of endometrial stromal sarcoma during in vitro fertilization (IVF) is rare. We encountered a case of endometrial stromal sarcoma (ESS) presenting as a new endometrial mass in a patient undergoing donor egg IVF, despite normal imaging and exams prior to and throughout treatment. To our knowledge, this is the only report describing the rapid growth of ESS during IVF treatment. When diagnosing an endometrial stromal sarcoma, it is important for the clinician and patient to be aware that full histologic inspection is required to distinguish it from a benign neoplasm. Given the need for a hysterectomy for definitive diagnosis, this case presents ethical challenges and potential for patient distress.
ISSN:2352-5789
2352-5789
DOI:10.1016/j.gore.2020.100541