PMC4274144_01
MRI features: preoperative (A, B) and 6 months after surgery (C-E).. Notes: (A) Saggital-T2 weighted imaging of well-defined uterine lesion with dishomogeneous signal intensity. (B) Axial-T2 weighted imaging with contrast enhancement showing early intense strengthening in the postenhancement phase. (C) Saggital-T2 weighted imaging of regular uterus. (D) Coronal-T2 weighted imaging of regular uterus. (E) Coronal-T1 weighted imaging with low-contrast enhancement in area of previous surgery. *indicates the uterine lesion.. Abbreviation: MRI, magnetic resonance imaging.
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No evidence of retroperitoneal lymphadenopathy, intraperitoneal disease, or regional metastases was shown (Figure 1A and B). TVS and MRI showed normal uterine size and vascularization pattern; no evidence of intraperitoneal disease or pelvic and para-aortic lymph node involvement was detected 6 months after surgery (Figure 1C-E).
Laparoscopic features: intraoperative (A-C) and 6 months after surgery (D-F).. Notes: (A) Panoramic view of intact uterus before the ESS enucleation. (B) Panoramic view of ESS during enucleation. (C) Panoramic view of uterus after ESS enucleation. (D-E) Panoramic view of disease-free pelvis and uterus. (F) Cromosalpingoscopy with direct visualization of bilateral transtubal methylene spillage.. Abbreviation: ESS, endometrial stromal sarcoma.
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Adnexa appeared normal; the uterus presented irregularities in morphology, but no signs of serosal involvement were found (Figure 2A-C).
Microscopic appearance with the appropriate pathological specimen description.. Notes: (A) The tumor showed an admixture of neoplastic cells arranged in cords and trabeculae with an island of lipidized cells. (B) These vacuolated cells were positive for inhibin, whereas the others (C) were strongly immunoreactive for SMA. In both components, MNF116 was widely positive (D). (Original magnification 10x).. Abbreviation: SMA, smooth muscle actin.
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There was strong nuclei antibody staining for estrogen and progesterone receptors (Figure 3A-D).