Endometrial stromal sarcoma

• Rare tumour arising from endometrial stroma
• Can be low or high grade
• Cells resemble endometrial stroma
• Infilrates myometrium and often lymphovascular spaces
• Typically presents with abnormal uterine bleeding but initial presentation may be as metastasis (most commonly ovary or lung)

Leiomyosarcoma (rare)

• A malignant smooth muscle tumour commonly displaying a spindle cell morphology
• Most occur in women >50 years
• Commonest symptoms abnormal vaginal bleeding, palpable pelvic mass and pelvic pain
• Poor prognosis even if confined to uterus at time of diagnosis
• Leiomyosarcoma and endometrial stromal sarcoma share the same staging system which is different to that for endometrial cancer

Carcinosarcoma

• Mixed tumour with malignant epithelial and stromal elements
• Heterologous elements commonly seen in about 50% cases (rhabdomyosarcoma, chrondrosarcoma, osteosarcoma)
• The presence of a rhabdomyosarcomatous component has the worst prognosis
• Usually associated with a poor outcome