Background: Pulmonary metastases as an initial presentation of primary uterine low-grade endometrial stromal sarcoma (LGESS) are extremely rare. Optimal treatment for such LGESS has not been established. Case Report: A 30-year-old woman presented with multiple pulmonary metastases on chest X-ray. Chest computed tomography (CT) revealed 11 pulmonary metastases measuring up to 2.8 cm. A uterine mass was detected during the workup and was diagnosed as LGESS by fine needle aspiration. Hysterectomy, right salpingo-oophorectomy, paraaortic and pelvic lymph node sampling, and omentectomy were performed. The left ovary was preserved since the surgery was performed with the aim of palliation and the patient refused to be in surgical menopause. She was then given high-dose megestrol acetate (800 mg/day) for 4 months followed by 200 mg/day for 20 months. The pulmonary metastases of LGESS began to regress with megestrol acetate treatment and almost completely disappeared 17 months after surgery. At this unexpected and satisfactory response to hormonal treatment, the remaining left ovary was also surgically removed. Since the surgery, the patient has been alive without symptomatic pulmonary metastases over 5 years on intermittent treatment of 200 mg megestrol acetate. Conclusion: Megestrol acetate could be suitable as the first-line hormonal treatment for pulmonary metastases from LGESS.

Keywords:
Endometrial stromal sarcoma, Megestrol acetate, Lung, Metastasis
This content is only available via PDF.
© 2010 S. Karger AG, Basel
2010
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.