Endometrial Sarcoma

Origin and causes

Endometrial sarcoma is an aggressive soft tissue cancer that develops in the uterus. It is the second most common subtype of uterine sarcoma. Endometrial sarcomas usually occur in the 5th to 6th decade of life. To date, no specific cause has been identified for the occurrence of this sarcoma. The most common subtypes of endometrial sarcomas are low-grade and high-grade endometrial sarcomas.

Symptoms and signs

These tumors can present as an abdominal mass, abdominal pain, or vaginal bleeding. Some patients may have lung or bone metastases at diagnosis.

Diagnosis

When a sarcoma is suspected, the initial evaluation includes either a CT scan or an MRI. The diagnosis is made by biopsy of the suspected area when possible. The evaluation may be supplemented by a chest CT scan or a PET scan. Sometimes, in the context of hysterectomy for uterine fibroids, an endometrial sarcoma may be discovered incidentally. After the evaluation, the stage of the cancer can be determined.

Treatment

When the endometrial sarcoma is localized, the treatment of choice is surgery to remove it. In some cases, radiotherapy after surgery may be necessary.

If metastases are found, chemotherapy is offered with the goal of controlling symptoms and disease progression. The preferred agents are: hormonal therapy, doxorubicin, gemcitabine-docetaxel, ifosfamide, liposomal doxorubicin, gemcitabine, and pazopanib. Clinical trials may also be explored.

Follow-up

After surgery, patients with endometrial sarcomas will be closely monitored due to the risk of recurrence (when the cancer returns).