ABSTRACT
Endometrial stromal sarcoma is a rare uterine mesenchymal tumor, the retroperitoneal location is rare. We update on the imaging features and histology of the tumor, as well as the interest to consider this diagnosis for surgery suitable for sarcomas. [60 years old patient with a history of hysterectomy and pelvic bilateral oophorectomy 10 years ago, allowed for a large abdominal mass pelvic MRI showed abdominopelvic mass lateralized to the left of heterogeneous signal with a fluid portion hyperintense Tl, T2 and diffusion and a fleshy portion enhanced after gadolinium injection, the patient was operated with residual tumor R2. Histological examination showed that this is a retro location peritoneal sarcoma endometrial stromal uterine origin of low grade [operated there 10 years] strongly expressing the estrogen receptor and progesterone . The evolution was marked by a recurrence with ureterohydronephrose and pelvic sarcoma . Endometrial stromal sarcoma is a rare mesenchymal tumor, but that it must be mentioned before an abdominal mass in a postmenopausal patient. The location is unusual ectopic outside the context of endometriosis. A replay of histological slides is often necessary. Immunohistochemistry showed positive CD10 expression and the estrogen and progesterone receptors. MRI tumor has a heterogeneous signal on T2 hyperintense with beaches . Tl weighted, they are in isotactic or hypointense relative to the signal of the myometrium . Signs for a sarcomatous origin are: taking early contrast; intense than that of the myometrium, the heterogeneous signal with necrotic areas . The prognosis is compounded by frequent recurrences, the only prognostic factor is the quality of the first surgical resection, involving resection in one piece without breaking capsular end to avoid the spread sarcoma C The specialized immunohistochemical study remains essential for the diagnosis of endometrial stromal sarcoma, and a good analysis of the imagery with topographical precision to end direct the surgical gesture to minimize the risk of recurrence