Stromal neoplasms are of three types---
endometrial stromal nodule: a benign tumor
low grade endometrial stromal sarcoma: malignant tumor with generally indolent behavior.
high grade endometrial stromal sarcoma: fully malignant tumor,unfavorable prognosis.
Endometrial stromal nodule is a rare mesenchymal tumor that accounts for one fourth of the endometrial stromal tumors. It is sometimes difficult to distinguish endometrial stromal nodule from stromal sarcoma.
Differential diagnosis depends on microscopic findings.
Endometrial stromal nodule being characterized by lack of infiltrating margins,lack of vascular/lymphatic invasion,minimal cytological atypia and mitotic activity.
DNA flow cytometric,ultrastructural,immunohistochemistry may also help.
Endometrial stromal tumors are commonly coexistent with leiomyomata and/or adenomyosis.
If the diagnosis is a endometrial stromal nodule, hysterectomy or local excision is recommended.
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