ENDOMETRIAL LOW-GRADE STROMAL SARCOMA WITH OVARIAN SEX-CORD-LIKE DIFFERENTIATION - REPORT OF 2 CASES WITH AN IMMUNOHISTOCHEMICAL AND FLOW-CYTOMETRIC STUDY

Two cases of endometrial low-grade stromal sarcoma with ovarian sex co rd-like differentiation occurring in a 39-year-old woman and a 42-year -old woman are presented, Both tumors, which were intramyometrial and measured 7.5 cm and 7.0 cm in greatest diameter, respectively, showed a multinodular, ill-demarcated, and yellowish white cut-surface, Histo logically, most parts of the tumors were composed of trabecular, cord- like, or plexiform arrangements that were reminiscent of the growth pa ttern seen in ovarian sex cord tumors, Features of conventional endome trial low-grade stromal sarcoma were only focally observed. The tumors showed infiltrative margins and lymphatic invasion, The tumor cells w ere positive for vimentin, desmin, alpha-smooth muscle actin, and musc le actin (HHF35). The tumors were also positive for both estrogen and progesterone receptors, Both tumors were DNA diploid as determined by flow cytometry, One patient had recurrences, including osteolytic lesi ons in the pelvic bones, but had no evidence of recurrence or metastas is 11 months after the last surgery, The other patient had no evidence of tumor in a limited follow-up, Familiarity with the neoplasm and ot her uterine mesenchymal tumors with ovarian sex cord-like differentiat ion by gynecologists and pathologists is essential in avoiding misdiag nosis because adjuvant hormonal therapy may be effective in treating l ow-grade stromal sarcomas.