Metastatic low-grade endometrial stromal sarcoma with variable morphologies in the ovaries and mesentery: A case report

Figure 1 Computed tomography of the whole abdomen and pelvis. A: A huge cystic and solid mass in the pelvic and abdominal cavity; B: There was also a large amount of fluid in the pelvic and abdominal cavity.

Figure 2 The right ovarian mass and the mesenteric mass in hematoxylin and eosin stain. A: The ovarian tumor has grown as a solid sheet (Original magnification: 40 ×; scale bar: 100 μm); B: In some areas, tumors cells have grown around small blood vessels (Original magnification: 200 ×; scale bar: 100 μm); C: The mesenteric tumor exhibits local invasion of the intestinal serosa and underlying muscle (Original magnification: 40 ×; scale bar: 100 μm); D: Cells have grown in a fishbone-like arrangement (Original magnification: 100 ×; scale bar: 100 μm).

Figure 3 Immunohistochemistry of the right ovarian tumor tissue and the mesenteric tumor tissue. A and E: The tumor cells are diffusely and strongly positive for estrogen receptor; B and F: Progesterone receptor; C and G: Wilms’ tumor 1; D and H: Cluster of differentiation 10. Original magnification: 200 ×; scale bar: 100 μm.

Figure 4 Biopsy material from the primary intrauterine tumor 20 years ago. A: Light microscopy examination shows that the tumor had infiltrated the adjacent vaginal smooth muscular layer as tongues or islands (Original magnification: 40 ×; scale bar: 100 μm); B: Small oval to fusiform cells resemble the cells of proliferative endometrial stroma and whirl around spiral arteriole-like vessels (Original magnification: 400 ×; scale bar: 100 μm).