A case of endometrial stromal sarcoma diagnosed by immunocytochemistry using cell transfer technique

Background : Endometrial stromal sarcoma (ESS) of the uterus, a rare neoplasm, is detected immunochemically by CD10 expression. We report a case of ESS diagnosed with immunocytochemistry using cell transfer. Case : A 68-year-old woman seen for abdominal swelling and suspected of having ovarian cancer following magnetic resonance imaging (MRI) underwent a hysterectomy with left adnexectomy. Touch cytology of the resected tumor showed numerous isolated cells that were spindle-shaped or markedly varied in size and shape against a hemorrhagic background. Neoplastic cells had indistinct cellular borders and enlarged nuclei, which showed a thin rim and a fine granular hyperchromatic pattern with distinct, irregular nucleoli. Immunocytochemically, neoplastic cells obtained by cell transfer were positive for CD10, yielding a diagnosis of ESS, compared to the histological diagnosis of high-grade ESS. Eighty days after surgery, tumors were detected surrounding the urinary bladder and subcutaneous abdomen. Aspiration cytology indicated neoplastic cells similar to the resected specimen and ESS metastasis. Tumors were resected, but the woman died 90 days postoperatively due to her worsened general condition. Conclusion : Immunocytochemical findings obtained with cell transfer were useful in definitively diagnosing ESS.