Hemorrhagic Brain Metastasis of Endometrial Stromal Sarcoma


  • Salih Gulsen Baskent University Medical Faculty Hospital - Neurosurgery, Maresal Fevzi Cakmak cad.10. sok. No: 45, Ankara 06540
  • Aysen Terzi Baskent University Medical Faculty - Pathology, Ankara
  • Ozlem Isiksacan Ozen Baskent University Medical Faculty - Pathology, Ankara
  • Ali Ayhan Baskent University Medical Faculty - Obstetrics and Gynecology, Ankara




stromal sarcoma, endometrium, cranium, metastasis, hemorrhage.


High-grade endometrial stromal sarcoma is a rare uterine malignancy. The cells of these tumors resemble endometrial cells in the proliferation stage, with many small plexiform arterioles. Herein we present a patient with endometrial stromal sarcoma that metastasized to the brain, along with the CT and MRI findings and a discussion of the surgical and histopathological features of the metastatic tumor. Immunohistopathological examination of the metastatic tumor showed a high mitotic rate and strong immunopositivity for CD10 and vimentin (as a mesenchymal marker); therefore, the lesion was considered to be high-grade endometrial stromal sarcoma. Due to the rarity of reported cases of metastatic brain tumors of high-grade endometrial stromal sarcoma, there isn’t a standard treatment protocol; however, metastatic tumors of high-grade endometrial stromal sarcoma match the same general concepts of brain metastasis. In addition, endometrial stromal sarcomas may be associated with hemorrhagic metastasis to the brain due to their pathologic characteristics.


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American Cancer Society. Cancer Facts and Figures 2009. Atlanta: American Cancer Society; 2009. Available from: http://www.cancer.org/ downloads/STT/500809web.pdf.

Madison T, Schottenfeld D, Baker V. Cancer of the corpus uteri in white and black women in Michigan, 1985-1994: an analysis of trends in incidence and mortality and their relation to histologic subtype and stage. Cancer. 1998;83:1546-54.

Sperduto PW, Berkey B, Gaspar LE, Mehta M, Curran W. A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1960 patients in the RTOG database. International Journal of Radiation Oncology Biology Physics. 2008; 70: 510– 4.

Tosoni A., Ermani M., Brandes A., The pathogenesis and treatment of brain metastases: a comprehensive review. Critical Reviews in Oncology/Hematology. 2004; 52: 199–215.

Acharya S, Hensley ML, Montag AC, Flaming GF. Rare uterine cancers. Lancet Oncol. 2005; 6:961-71.

Chan JK, Kawar NM, Shin JY, Osann K, Chen LM, Powell CB, et al. Endometrial stromal sarcoma: a population-based analysis. Br J Cancer. 2008; 99:1210-8.

Haberal A, Kayıkcıoglu F, Boran N, Calıskan E, Ozgul N, Kose MF. Endometrial stromal sarcoma of the uterus: analysis of 25 patients. Eur J Obstet Gynecol Reprod Biol. 2003;109(2):209-13.

Inayama Y, Shoji A, Odagiri S, Hirahara F, Ito T, Kawano N, et al. Detection of pulmonary metastasis of low-grade endometrial stromal sarcoma 25 years after hysterectomy. Pathol Res Pract. 2000;196:129-34.

Amant F, Moerman P, Vergote I. The classification of a uterine sarcoma as ‘High-grade endometrial stromal sarcoma’ should be abandoned. Gynecol Oncol. 2004; 95:412-3.

Thomas MB, Keeney GL, Podratz KC, Dowdy SC. Endometrial stromal sarcoma: treatment and patterns of recurrence. Int J Gynecol Cancer. 2009; 19:253-6.

Nordal RR, Kristensen GB, Kaern J, et al. The prognostic significance of surgery, tumor size, malignancy grade, menopausal status, and DNA ploidy in endometrial stromal sarcoma. Gynecol Oncol. 1996;62:254-9.

Blecharz P, Urbański K, Mucha-Małecka A, Małecki K, Reinfuss M, Jakubowicz J, Skotnicki P. Hematogenous metastases in patients with Stage I or II endometrial carcinoma. Strahlenther Onkol. 2011;187(12):806-11,2011.

Ogawa K, Yoshii Y, Aoki Y et al. Treatment and prognosis of brain metastases from gynecological cancers. Neurologia Medico-Chirurgica. 2008; 48: 57–62.

Huang MI, Debernardo RL, Rodgers M, Hart DJ. Endometrial stromal sarcoma metastasis to the lumbar spine and sphenoid bone. Rare Tumors. 2011;3(3):e27.

Akhavan A, Shishebor F, Moghimi M, Binesh F. Endometrial stromal sarcoma of uterus with metastasis to the lung and brain. BMJ Case Rep. 2012;2012.

Merinsky A, Schmidt M, Heidner K, Koelbl H. Cerebral metastases of an endometrial stromal sarcoma: report of the first case. Onkologie. 2012; 35(5):272-4.

Stofko DL. Undifferentiated uterine sarcoma metastatic to the brain. Surg Neurol Int. 2013;27:4-12.

Bhargava R, Shia J, Hummer AJ, Thaler HT, Tornos C, Soslow RA. Distinction of endometrial stromal sarcomas from 'hemangiopericytomatous' tumors using a panel of immunohistochemical stains. Mod Pathol. 2005;18:40-7.




How to Cite

Gulsen S, Terzi A, Ozen OI, Ayhan A. Hemorrhagic Brain Metastasis of Endometrial Stromal Sarcoma. Open Access Maced J Med Sci [Internet]. 2014 Jun. 15 [cited 2022 Aug. 13];2(2):309-12. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2014.052



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