Endometrial stromal sarcoma, pathology, diagnosis, management and treatment. (Theoretical Review)

Abstract

Introduction: Uterine sarcomas account for 3 to 7% of female neoplasms and due to their rarity, unknown etiology, and genetic aberration, there is a lack of agreement on the factors of occurrence and therapeutic options. Endometrial stromal tumors account for less than 1% and are divided into four categories recognized by the World Health Organization: endometrial stromal nodule, low-grade endometrial stromal sarcoma, high-grade endometrial stromal sarcoma, and undifferentiated uterine sarcoma. Total hysterectomy with bilateral salpingo-oophorectomy is the main line of treatment. Objective: Carry out an updated bibliographic review of the pathophysiology, incidence, clinical picture, diagnosis, and treatment of uterine endometrial sarcoma, with the purpose of identifying the state of knowledge and resolution of this pathology worldwide. Methodology: A bibliographic search was carried out in the databases: PUBMED, CANCERLIT, EMBASE, BIREME, and HINARI, selecting articles published in the last 10 years, in any language, which were not limited by design or number of notified patients, which refer to accurate information about endometrial sarcoma. Results: 68 useful articles were identified, 47 met the eligibility criteria from which it can be inferred that immunohistochemistry determines the definitive diagnosis and that recurrence depends on the type of endometrial sarcoma identified.  Conclusion: Endometrial sarcoma is a rare neoplasm, with variable and nonspecific clinical manifestations, that affects pre- and postmenopausal women. Early diagnosis and timely intervention are necessary for patient survival.