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Colon tumor

Mesenchymal tumors

Endometrial stromal sarcoma of colon

Reviewers: Charanjeet Singh, M.D. (see Reviewers page)
Revised: 29 September 2014, last major update March 2012
Copyright: (c) 2003-2014, PathologyOutlines.com, Inc.


● Rare complication of endometriosis and unopposed estrogen therapy (Am J Surg Pathol 2000;24:513)
● Uterine primary tumors may also recur in colon (World J Gastroenterol 2005;11:2367, Eur J Gynaecol Oncol 2006;27:297)
● Typically no death from disease (J Korean Med Sci 2002;17:412)

Case reports

● 46 year old woman with tumor in bowel wall and mesentery (Eur J Gynaecol Oncol 2005;26:113)
● 53 year old woman with tumor in mesentery (Ginekol Pol 2004;75:150)
● 61 year old woman with portal vein thrombosis (Arch Pathol Lab Med 2001;125:1088)

Gross description

● Tumor often arises in serosa or bowel wall

Micro description

● Tongue-like growth of tumor nodules composed of densely packed, plump spindle cells in short fascicles and interspersed with prominent small arterioles
● Tumor cells resemble proliferative endometrium with scanty ill-defined cytoplasm and round or ovoid nuclei with dispersed chromatin
● Often angiolymphatic invasion and perineural invasion despite low grade features
● No / minimal pleomorphism or mitotic figures
● Note: must see normal endometrial tissue to document malignant transformation of endometriosis

Micro images


Metastatic tumor to colon; PgR+ tumor

Various images

Positive stains

● Vimentin, ER, PgR and CD10
● Variable NKI/C3 and weak CD68

Negative stains

● Cytokeratin, EMA, S100, CD34, CD117, desmin and actin (muscle markers may be positive in epithelioid areas, Int J Gynecol Pathol 2002;21:48)

Differential diagnosis

GIST: CD117+

End of Colon tumor > Mesenchymal tumors > Endometrial stromal sarcoma of colon

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