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Diagnosis: Types of Tumors

Epithelial Cancer: Sarcoma
Although primary pure or mixed sarcomas of the ovary are very uncommon, they constitute a heterogeneous group with four different types of neoplasms: endometrioid stromal sarcoma, adenosarcoma, sarcoma arising in a mature teratoma, and miscellaneous soft tissue sarcomas. All of these tumors are extremely rare. Endometrioid stromal sarcoma (ESS) is an extremely rare primary ovarian neoplasm. Among approximately 27 reported cases, 63% have been closely associated with endometriosis from which the tumor may have arisen. The mean patient age is 52 years. The mean tumor size is 10 cm. Over 70% present in advanced stage (FIGO II-III). Since primary uterine ESS is often slow growing and prone to late recurrence, it is important to consider the possibility of metastatic tumor from a uterine primary, even if the patient has had a hysterectomy in the remote past. The behavior appears to parallel that of advanced stage uterine ESS, although data are limited.

Mullerian adenosarcoma of the ovary is very rare. In a series of five cases, the mean patient age was 46, and the median tumor size was over 15 cm. Two were stage I and three were stages II and III. After limited follow up with a mean of 3.4 years, two patients were alive with disease, two were alive and well and one died of unrelated causes.

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