{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T14:04:28Z","timestamp":1771855468910,"version":"3.50.1"},"reference-count":22,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,4]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Endometrial stromal sarcoma (ESS) is a rare uterine malignancy originating from endometrial connective tissue. It is classified into benign and malignant subtypes. While it primarily affects perimenopausal women aged 45\u201355 years, younger patients may also be affected. ESS often presents with symptoms such as abnormal uterine bleeding, pelvic pain or pelvic mass, mimicking benign conditions like fibroids. Definitive treatment includes total hysterectomy with bilateral salpingo-oophorectomy, complemented by hormonal therapy for advanced cases.<\/jats:p>\n                  <jats:p>Despite its indolent nature, low-grade ESS (LGESS) requires long-term follow-up due to significant recurrence risk. We present a case of a woman in her late 20s, who underwent hysterectomy for severe bleeding and anaemia, with LGESS diagnosed later during a growing abdominal wall mass evaluation.<\/jats:p>\n                  <jats:p>Imaging and biopsy confirmed her diagnosis. She underwent extensive debulking surgery. Histological analysis revealed oval to spindle cells, low mitotic activity, no necrosis or atypical mitotic figures; Estrogen Receptor (ER), Progesterone Receptor (PR) and CD10 positivity, which were consistent with LGESS.<\/jats:p>","DOI":"10.1136\/bcr-2025-266372","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T13:05:22Z","timestamp":1771851922000},"page":"e266372","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Post-hysterectomy presentation of low-grade endometrial stromal sarcoma (LGESS): a clinical challenge in uterine malignancies"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2218-9560","authenticated-orcid":false,"given":"Shaloo","family":"Priya","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3651-1050","authenticated-orcid":false,"given":"Bhawna","family":"Arora","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6219-9970","authenticated-orcid":false,"given":"Rajesh","family":"Kumari","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8364-0737","authenticated-orcid":false,"given":"Jyoti","family":"Meena","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"2026022305051357000_19.2.e266372.1","unstructured":"Herrington S , WHO Classification of Tumors Editorial Board. Female genital tumours . Female genital tumours. international agency for research on cancer. World Health Organization; 2020."},{"key":"2026022305051357000_19.2.e266372.2","unstructured":"Gilks B . Uterus: corpus. In: Goldblum J , Lamps LW , McKenney JK , et al ., eds. Rosai and ackerman\u2019s surgical pathology. Philadelphia: Elsevier, 2018: 1318\u201322."},{"key":"2026022305051357000_19.2.e266372.3","first-page":"1","article-title":"Endometrial stromal sarcoma: A review of the literature","volume":"33","author":"Puliyath","year":"2012","journal-title":"Indian J Med Paediatr Oncol"},{"key":"2026022305051357000_19.2.e266372.4","doi-asserted-by":"crossref","first-page":"098","DOI":"10.1055\/s-0040-1708628","article-title":"Low Grade Endometrial Stromal Sarcoma\u202f: Report of a Rare Uterine Malignancy","volume":"06","author":"Shetty","year":"2016","journal-title":"Journal of Health and Allied Sciences NU"},{"key":"2026022305051357000_19.2.e266372.5","doi-asserted-by":"crossref","first-page":"284","DOI":"10.6004\/jnccn.2025.0038","article-title":"NCCN Guidelines\u00ae Insights: Uterine Neoplasms, Version 3.2025: Featured Updates to the NCCN Guidelines\u00ae","volume":"23","author":"Abu-Rustum","year":"2025","journal-title":"J Natl Compr Canc Netw"},{"key":"2026022305051357000_19.2.e266372.6","doi-asserted-by":"crossref","unstructured":"Jian H , Guo J , Zhao W , et al . 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