Endometrial stromal sarcoma: Objective response to letrozole

Background. Low-grade endometrial stromal sarcoma is generally an indolent tumor rich in estrogen and progesterone receptors. Objective responses to h ormonal therapy, most commonly with megestrol acetate, have been reported. Case. The patient is a 51-year-old woman who presented with low-grade endom etrial stromal sarcoma confined to the uterus in 1991 and was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy. Approxima tely 5 years later, the patient had recurrent pelvic disease treated with r adiation therapy, followed by an attempt at resection. She was treated with megestrol acetate during the period she received radiation therapy with po or tolerance. Tamoxifen was then given with no tumor response. Megestrol ac etate was restarted with progression of disease in the pelvis and abdomen. Letrozole was then given at a daily dose of 2.5 mg with partial response fo r a duration of 9 months. Conclusion. Letrozole at a daily dose of 2.5 mg may be effective in low-gra de endometrial. stromal. sarcoma with positive estrogen receptors. (C) 2001 Academic Press.