Endometrial stromal sarcoma is the second most common category of uterine mesenchymal tumors. They are very rare malignant tumors comprises of 0.2% of all uterine malignancies. It usually affects  women with mean age of 42 to 58 years. They account less than 10% of uterine mesenchymal neoplasm and about 10 to 25% of postmenopausal women are affected.

Case Details:

A 28-year-old female patient came with complaints of abdominal pain for 1 month. She had history of dysmenorrhea and heavy menstrual bleeding.

Contrast enhanced MRI reveals well enhanced heterogenous lesion predominantly hyper intense on lateral wall of uterus. Differentials include Leiomyoma and stromal tumors of uncertain malignant potential.

Endometrial biopsy was done and shows Endometrial hyperplasia without atypia. Myomectomy was done. On histopathological examination, the following differentials were considered 1.Endometrial stromal sarcoma and 2. Leiomyosarcoma. Further advised for Hysterectomy and IHC. Hysterectomy was performed and final impression was Low grade endometrial stromal sarcoma based on morphology and IHC markers.


This case is an unusual presentation in an young female presented as myometrial mass without the involvement of endometrium.

Key Words:

Leiomyosarcoma, Endometrial Stromal sarcoma.