Endometrial stromal sarcoma of colon

Colon tumor
Mesenchymal tumors
Endometrial stromal sarcoma of colon

Author: Raul S. Gonzalez, M.D. (see Authors page)

Revised: 4 January 2017, last major update November 2016

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: endometrial stromal sarcoma colon

Table of Contents

Cite this page: Endometrial stromal sarcoma of colon. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumorESS.html. Accessed July 14th, 2017.

Definition / general

Endometrial stromal sarcomas may rarely arise from colonic endometriosis (Am J Surg Pathol 2000;24:513)

Essential features

Rare primary tumor arising from colonic endometriosis
Most endometrial stroma sarcomas involving the colon representing recurrence or metastasis from a uterine primary

Clinical features

Average age 51 years; typically no death from disease (J Korean Med Sci 2002;17:412)

Case reports

61 year old woman with rectosigmoid endometrial stromal sarcoma (Arch Pathol Lab Med 2001;125:1088)
80 year old woman with history of hysterectomy 37 years prior (Case Rep Obstet Gynecol 2013;2013:202458)

Gross description

Tumor often arises in serosa or bowel wall

Microscopic (histologic) description

Tongue-like growth of densely packed, plump spindle cells in short fascicles
Scanty, ill defined cytoplasm and round or ovoid nuclei with dispersed chromatin
Minimal pleomorphism or mitoses
Often lymphovascular invasion and perineural invasion despite low grade appearance
Endometriosis present in background

Microscopic (histologic) images

Images hosted on other servers:

Various images

Colonic endometrial stromal sarcoma

Positive stains

Vimentin, ER, PR, CD10
Desmin and actin may be positive in epithelioid areas (Int J Gynecol Pathol 2002;21:48)

Negative stains

Cytokeratin, EMA, S100, CD34, CD117

Differential diagnosis

Gastrointestinal stromal tumor: positive for CD117 and DOG1
Leiomyosarcoma: positive for smooth muscle actin in spindled areas
Malignant gastrointestinal neuroectodermal tumor: positive for S100 (Am J Surg Pathol 2012;36:857)
Metastasis from uterine primary: history of primary tumor; no endometriosis in colon