Imrana Masroor


Endometrial stromal sarcoma (ESS) is a rare malignancy arising from the stromal cells of the endometrium. We present a case of a 38-year-old female who was admitted to the Emergency Room (ER) with heavy and foul-smelling vaginal bleeding. Further workup (examination) revealed a bulky uterus with a fibroid extending into the cervix. Ultrasound and MRI pelvis showed a large submucosal uterine fibroid with concerning features of possible rupture. The patient underwent total abdominal hysterectomy with bilateral salpingectomy. Intraoperatively, the fibroid was found to be necrotic and macerated, coming out of the cervical os. Histopathology examination revealed a low-grade ESS. The patient was discharged in stable condition. Follow-up imaging and clinical evaluations have shown no evidence of recurrence at three-months post-surgery.


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