Treatment of Recurrent Endometrial Stromal Sarcoma with Letrozole: A Case Report and Literature Review

  title={Treatment of Recurrent Endometrial Stromal Sarcoma with Letrozole: A Case Report and Literature Review},
  author={Vonetta Sylvestre and Charles J Dunton},
  journal={Hormones and Cancer},
Endometrial stromal sarcomas are rare tumors that recur long after initial excision. We report a case of recurrent endometrial stromal sarcoma treated with the aromatase inhibitor letrozole and an overview of research completed to date. A 59-year-old female presented with new abdominal onset pain, fatigue, and nausea. She had a computed tomography that showed a pelvic mass, an enlarged right internal iliac lymph node, an atypical liver hemangioma, and a severe left hydronephrosis. The patient… 

Conservative management of endometrial stromal sarcoma at stage III: A case report

Conservative management of a 19-year-old female with ESS at stage III who underwent a local mass resection by laparoscopic surgery resulted in complete remission of the low-grade ESS, with no sign of recurrence at the 33-month follow-up.

Hormonal treatments in metastatic endometrial stromal sarcomas: the 10-year experience of the sarcoma unit of Royal Marsden Hospital

In this cohort of metastatic ESS patients, 1st line endocrine treatment achieved objective response in 46.2% of them and clinical benefit in 92.4%.

Pulmonary Metastasizing Low-Grade Endometrial Stromal Sarcoma: Case Report and Review of Diagnostic Pitfalls

A 70-year-old woman with a history of hysterectomy for uterine leiomyoma and two subsequent episodes of acute, recurrent respiratory distress, accompanied by massive pleural effusions and hydropneumothorax over the next two years is diagnosed with low-grade endometrial stromal sarcoma, a rare uterine tumor.

Systemic therapy for endometrial stromal sarcomas: current treatment options.

In steroid receptor positive advanced LG-ESS hormonal therapy, mainly with progestins, allows in some patients for a long-term survival, and aromatase inhibitors seem to be equally effective as first- and subsequent-line of treatment, and are well tolerated.

Durable Response to Letrozole in a Patient with Relapsed Low Grade Endometrial Stromal Sarcoma Metastatic to the Lung - A Case Report

A 55-year-old female patient with relapsed LGESS in the lungs, who achieved almost complete response to letrozole for more than 6 years, is reported, which is the longest reported durable response with letroZole in patients with LGESS and lung metastasis.

Aromatase inhibitor therapy for endometrial stromal sarcoma - two-centre experience.

There is evidence of aromatase inhibitors efficacy as long-term endocrine treatment option for ESS patients with advanced or unresectable recurrent estrogen, progesterone and androgen receptor-positive ESS.

Hormonal therapy in gynecological sarcomas

A critical appraisal of the existing data regarding hormonal manipulation in uterine sarcomas is included and attempts to make recommendations for endocrine treatments in specific settings, as well as suggest targets/medications for future research.

Long-Term Outcome of Aromatase Inhibitor Therapy With Letrozole in Patients With Advanced Low-Grade Endometrial Stromal Sarcoma

Letrozole as well as progestins could be the first choice of treatment for patients with recurrent or residual LGESS, which is difficult to resect surgically because of its efficacy and minimal adverse effects.

Long-term treatment of residual or recurrent low-grade endometrial stromal sarcoma with aromatase inhibitors: A report of two cases and a review of the literature.

In conclusion, aromatase inhibitors, particularly third-generation drugs, are a well-tolerated class of medications that are effective in the treatment of advanced low-grade ESS, with a favorable toxicity profile.



Long-term survival of patients given hormonal therapy for metastatic endometrial stromal sarcoma

The data suggest that an aromatase inhibitor may be an effective treatment for ESS, and routine ER and PR analyses could be useful to predict the response to hormonal therapy in ESS.

Management of late recurrence of a low-grade endometrial stromal sarcoma (LGESS): treatment with letrozole.

The case of a 36-year-old woman who underwent an abdominal hysterectomy with bilateral salpingo-oophorectomy and adjuvant radiotherapy for a G1 LGESS in 1991 and 12 years later she presented to us with pelvic and peritoneal masses is reported.

Hormonal therapy of endometrial stromal sarcoma

Hormonal therapy with progestins, aromatase inhibitors and gonadotropin-releasing hormone analogues has become an effective treatment alternative to radiation and chemotherapy for low-grade endometrial stromal sarcoma patients.

Pathology of uterine malignancies.

  • L. Brown
  • Medicine
    Clinical oncology (Royal College of Radiologists (Great Britain))
  • 2008

The epidemiology of sarcomas of the uterus.

The age-incidence pattern of uterine leiomyosarcoma resembles that of carcinomas of the female reproductive tract, unlike the pattern of other uterine sarcomas or sarcoma occurring elsewhere.

Aromatase expression in low-grade endometrial stromal sarcomas: an immunohistochemical study

The high percentage of aromatase positivity in low-grade endometrial stromal sarcomas may have implications in the management of these tumors and offer new treatment modalities such as hormonal therapy with aromatases inhibitors.

Letrozole. A review of its use in postmenopausal women with advanced breast cancer.

Letrozole should be recommended as a second-line treatment in postmenopausal women with advanced breast cancer whose disease has progressed on or failed to respond to antiestrogen therapy and offers greater selectivity and potency of aromatase inhibition than the prototype aromat enzyme inhibitor, aminoglutethimide, and can be administered once daily.