Recurrent endometrial stromal sarcoma after treatment with high-dose chemotherapy and autologous stem-cell support: A case report

Introduction: The efficacy of high-dose chemotherapy plus transplantation of autologous hematopoetic stem cells in patients with endometrial stromal sarcomas is unknown.

Case report: A 39-year-old woman with Stage III endometrial stromal sarcoma (ESS) underwent radical surgery, followed by five courses of ifosfamide, adriamycin and dacarbazine postoperatively. Six months after primary surgery stem cell priming was performed. Five months later bone marrow was aspirated and high-dose chemotherapy with carboplatin, vepeside and holoxan were administered after which bone marrow was retransfused. Seven years after primary surgery the patient developed an abdominal recurrence which was removed surgically and adjuvant radiotherapy was administered. One year later the patient underwent hemicolectomy because of a new recurrence infiltrating the ascending colon. Treatment with 25 mg exemestane was begun. The patient is currently alive and free of disease nine years after the initial diagnosis.

Conclusion: Aggressive chemotherapy with autologous stem-cell support seems to be ineffective in patients with ESS.

Endometrial stromal sarcoma; Treatment; High-dose chemotherapy; Stem-cell support

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