Endometrial stromal sarcoma in a 25-year-old patient

Abstract

Objective: To report the case of a young patient with endometrial stromal sarcoma, treated at the gynecological surgery department of a Regional Hospital within the public healthcare network of the Federal District. Case details: A 25-year-old nulliparous patient with no comorbidities, admitted with complaints of irregular vaginal bleeding and hypermenorrhea for approximately one year, who had been using desogestrel for 30 days. Speculum examination revealed a tumor mass of approximately 4 cm protruding through the external cervical os, with an initial diagnostic hypothesis of a prolapsed uterine fibroid. A biopsy and immunohistochemical analysis of the specimen were performed, confirming the diagnosis of low-grade endometrial stromal sarcoma. Therefore, total hysterectomy with bilateral salpingo-oophorectomy was indicated. Final considerations: The diagnosis of the disease is considered to be established after histological confirmation, highlighting the importance of clinical suspicion, appropriate investigation, and early diagnosis in order to ensure a better prognosis and survival for patients. Thus, surgical management and long-term follow-up are required due to the high risk of recurrence and late metastasis.