Low-grade endometrial stromal sarcoma: differential with uterine leiomyoma: A rare case report

Endometrial stromal tumors are extremely rare uterine malignancy, mainly among young females. Herein, we report a case of low-grade endometrial stromal tumor in a 19-year-old women who presented with the non-specific symptoms of lower abdominal pain, swelling and vaginal bleeding similar to the uterine leiomyoma. Ultrasound finding showed bulky uterus with multiple fibroid and degenerative changes. Contrast enhanced computed tomography (CECT) displayed diffusely enlarged uterus with heterogenous enhancement of the solid cystic mass with normal bilateral tubes and ovary. Considering the patient in the reproductive age group and her fertility status, she was operated with surgical subtotal hysterectomy. Histopathological examination and immunohistochemistry confirmed the diagnosis of Low-Grade Endometrial Stromal Sarcoma (LG-ESS). Patient was closely followed up for recurrence. Endometrial Stromal Sarcoma (ESS) should be included in the differential diagnosis of uterine leiomyoma to avoid recurrence of the lesion.