{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:34:52Z","timestamp":1787841292837,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2015,7,1]],"date-time":"2015-07-01T00:00:00Z","timestamp":1435708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2015,1,6]],"date-time":"2015-01-06T00:00:00Z","timestamp":1420502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Endometrial stromal sarcoma (ESS) is an extremely rare neoplasm accounting for only 0.2% of all uterine malignancies and for 15-26% of primary uterine sarcomas. The annual incidence of ESS is 1-2 per million women. Herein, to the best of our knowledge, we present the first reported case of ESS of the vulva in a 50-year-old female presenting with per vaginal spotting over a period of three months. Her past surgical history included a subtotal hysterectomy and left salpingo-oophorectomy for uterine fibroids ten years previously. On examination, a 3.5 \u00d7 3 \u00d7 2 cm cystic mass was found in the right labia majora. The mass was excised and the diagnosis of endometrial stromal sarcoma was made. Subsequent metastatic workup was negative and the patient was started on megestrol acetate. She has remained disease free with no signs or symptoms of recurrent or advanced disease for 28 months.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.hemonc.2014.12.003","type":"journal-article","created":{"date-parts":[[2015,1,6]],"date-time":"2015-01-06T12:50:10Z","timestamp":1420548610000},"page":"125-129","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Vulvar extrauterine endometrial stromal sarcoma"],"prefix":"10.4103","volume":"8","author":[{"given":"Khaled J","family":"Zaza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A","family":"Arafah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail A","family":"Al-Badawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"15","key":"10.1016\/j.hemonc.2014.12.003_b0005","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.3748\/wjg.v11.i15.2367","article-title":"Metastatic low-grade endometrial stromal sarcoma of the sigmoid colon three years after hysterectomy","volume":"11","author":"Asada","year":"2005","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.hemonc.2014.12.003_b0010","series-title":"Pathology and Genetics of Tumours of the Breast and Female Genital Organs","first-page":"233","article-title":"(WHO) World Health Organization classification of tumours","author":"Tavassoli","year":"2003"},{"key":"10.1016\/j.hemonc.2014.12.003_b0015","series-title":"World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Breast and Female Genital Organs","first-page":"233","article-title":"Mesenchymal tumors and related lesions","author":"Hendrickson","year":"2003"},{"issue":"4","key":"10.1016\/j.hemonc.2014.12.003_b0020","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/00004347-199310000-00002","article-title":"Primary extrauterine endometrial stromal neoplasms: a clinicopathologic study of 20 cases and a review of the literature","volume":"12","author":"Chang","year":"1993","journal-title":"Int J Gynecol Pathol"},{"issue":"2","key":"10.1016\/j.hemonc.2014.12.003_b0025","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.anndiagpath.2006.03.020","article-title":"Endometrial stromal sarcoma of the small bowel","volume":"12","author":"Kim","year":"2008","journal-title":"Ann Diagn Pathol"},{"issue":"11","key":"10.1016\/j.hemonc.2014.12.003_b0030","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1097\/PAS.0000000000000083","article-title":"Endometrioid stromal sarcoma: a clinicopathologic study of 63 cases","volume":"37","author":"Masand","year":"2013","journal-title":"Am J Surg Pathol"},{"issue":"11","key":"10.1016\/j.hemonc.2014.12.003_b0035","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1097\/01.pas.0000138002.46650.95","article-title":"Cellular angiofibroma: clinicopathologic and immunohistochemical analysis of 51 cases","volume":"28","author":"Iwasa","year":"2004","journal-title":"Am J Surg Pathol"},{"issue":"2","key":"10.1016\/j.hemonc.2014.12.003_b0040","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.ygyno.2004.03.048","article-title":"Endometrial pathologies associated with postmenopausal tamoxifen treatment","volume":"94","author":"Cohen","year":"2004","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.hemonc.2014.12.003_b0045","first-page":"202458","article-title":"A case of extrauterine endometrial stromal sarcoma in the colon diagnosed three decades after hysterectomy for benign disease","volume":"2013","author":"Ayuso","year":"2013","journal-title":"Case Rep Obstet Gynecol"},{"issue":"9","key":"10.1016\/j.hemonc.2014.12.003_b0050","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1002\/1097-0142(19821101)50:9<1888::AID-CNCR2820500940>3.0.CO;2-K","article-title":"Endolymphatic stromal myosis. 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