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Case Reports in Obstetrics and Gynecology
Volume 2015, Article ID 376817, 4 pages
http://dx.doi.org/10.1155/2015/376817
Case Report

Endometrial Stromal Nodule: A Rarity and a Pathological Challenge

1Department of Obstetrics and Gynecology, Viborg Regional Hospital, 8800 Viborg, Denmark
2The Fertility Clinic, Skive Regional Hospital, 7800 Skive, Denmark
3Faculty of Health, University of Aarhus, 8000 Aarhus, Denmark
4Department of Pathology, Viborg Regional Hospital, 8800 Viborg, Denmark

Received 18 April 2015; Accepted 14 June 2015

Academic Editor: Joo-Hyun Nam

Copyright © 2015 Camilla Skovvang Borg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Endometrial stromal tumors are rare, and endometrial stromal nodule is the least common. In the region of Middle Jutland, Denmark, only two cases are reported since 1995. The nodules are benign; nevertheless, hysterectomy is the treatment of choice. Tumor margins are required for diagnosis and essential to differentiate it from an invasive stromal sarcoma whose prognosis is very different. We report a rare case of a 38-year-old woman, with presurgical diagnosis of a uterine tumor/polyp. She presented with nausea and changes in bleeding pattern and initially had a transcervical polyp resection performed. Histopathological examination showed the presence of an endometrial stromal tumor with unclear margins, and an invasive malignant endometrial sarcoma could not be excluded. Pathological examination revealed an endometrial stromal nodule with invasion, not exceeding three mm. Endometrial stromal tumors are interesting due to their rare existence and difficulties in establishing a histological diagnosis. Although endometrial stromal nodules are benign entities, they must be differentiated from the other invasive malignant stromal tumors, which may change the final prognosis. No preoperative diagnostic tools are at hand, and benign as well as malignant tumors are treated with hysterectomy.