Hyalinizing spindle cell tumor with giant rosettes (HSCTGR) is unusual, recently recognized entity, histologically characterized by the presence of large rosette-like structures. Apart from these formations, histological features of HSCTGR are indistinguishable from low-grade fibromyxoid sarcoma (LGFMS), and available data suggest that these two tumors present different variants of the same entity.
Herein we report the case of HSTCGR found in the uterus. To our knowledge, the present case is the first description of HSTGR occurring at this location as well as the first HSCTGR described in the Croatian medical literature.
A 38-year-old woman presented to her gynecologist with symptoms of acute pain in the lower abdomen. Gynecological ultrasound examination showed an enlarged uterus with a tumor mass. Total hysterectomy and bilateral adnexectomy with selective pelvic and para-aortal lymphadenectomy were performed. Serial slicing of the enlarged uterus revealed a grayish white tumor mass with 15 cm in maximum length. The margins of the tumor merged with the uterine wall and the tumor infiltrated more than one half of the myometrium. Histologically, the tumor showed typical features of HSTGR.
Postoperatively, no complications occurred.
Twenty-two months after surgery, our patient is alive with no signs of recurrence. She needs to be followed up for a long period because HSTCGR belongs to a low-grade malignancy group with the potential to recur and produce late metastasis.Hijalinizirajući tumor vretenastih stanica s gigantskim rozetama (HSCTGR) rijedak je, relativno nedavno opisan entitet, čija je histološka značajka stvaranje krupnih struktura koje nalikuju rozetama. Osim po prisutnosti ovih tvorbi, histološki ga se ne može razlikovati od fibromiksoidnog sarkoma niskoga gradusa i danas se vjeruje da su oni različite varijante istog entiteta.
Opisujemo hijalinizirajući tumor vretenastih stanica s gigantskim rozetama nađen u uterusu. Prema našim spoznajama radi se o prvom slučaju opisanom na toj lokalizaciji te također prvom slučaju HSCTGR u hrvatskoj medicinskoj literaturi.
Dotada zdrava 38-godišnja žena javila se ginekologu zbog akutne boli u donjem dijelu abdomena. Ginekološkim i ultrazvučnim pregledom nađena je veća tumorska tvorba u području uterusa. Učinjena je histerektomija s adneksektomijom i selektivnom limfadenektomijom. Serijskim rezovima kroz stijenku povećanog uterusa prikazao se sivkastobjelkasti tumor najvećeg promjera 15 cm, koji je infiltrirao više od ½ debljine miometrija. Patohistološkom analizom postavljena je dijagnoza HSCTGR.
Postoperativni je tijek prošao bez komplikacija, a 22 mjeseca nakon operacije naša je pacijentica bez znakova recidiva bolesti. HSCTGR pripada skupini tumora s niskim malignim potencijalom te mogućnošću recidiviranja i metastaziranja nakon više godina, stoga se preporučuje dugoročno kliničko praćenj
