{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:18:28Z","timestamp":1783678708588,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: The primary occurrence of low-grade endometrial stromal sarcoma (LG-ESS) at extrauterine sites, termed extrauterine ESS (EESS), is exceedingly rare. Case Presentation: A 49-year-old female, gravida 2 para 2 (all deliveries by cesarean section), presented with a 1-month history of epigastric and left upper quadrant abdominal pain. Abdominal computed tomography revealed a lobulated mass, measuring 4.6 cm, in the left upper quadrant with focal attachment to the splenic flexure of the colon. She underwent a laparoscopic partial gastrectomy and colectomy at a referral institution. Surgical pathology identified a 6.0 \u00d7 5.0 \u00d7 4.0 cm lobulated tumor involving the stomach with colonic invasion, diagnosed as LG-ESS (pT3N0). Immunohistochemistry showed a CD10-reactive lesion. The patient was referred to our institution for definitive gynecological surgery. After prophylactic ureteral double-J catheter insertion, she underwent laparoendoscopic single-site (LESS) total hysterectomy with bilateral salpingo-oophorectomy. The final histopathological examination of the hysterectomy specimen revealed intramural leiomyomas and benign ovarian cysts, with no evidence of ESS within the uterine corpus or adnexa. These findings confirmed a true primary EESS of nonuterine origin, consistent with AJCC stage 3 disease. The patient recovered uneventfully and was discharged during outpatient follow-up. Conclusions: This case represents one of the very few reported instances of primary LG-EESS involving the stomach and colon, simultaneously managed with a staged multidisciplinary surgical approach, including gastrointestinal resection followed by LESS hysterectomy and bilateral salpingo-oophorectomy.<\/jats:p>","DOI":"10.3390\/diagnostics16142157","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:46:47Z","timestamp":1783676807000},"page":"2157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extrauterine Low-Grade Endometrial Stromal Sarcoma: A Case Report and Review of the Literature"],"prefix":"10.3390","volume":"16","author":[{"given":"Jie-Yu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9996-0428","authenticated-orcid":false,"given":"Chiu-Hsuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Digital Pathology, Department of Anatomical Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"},{"name":"Department of Pathology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5105-068X","authenticated-orcid":false,"given":"Dah-Ching","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan"},{"name":"Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e148144","DOI":"10.5812\/ijcm-148144","article-title":"Low Grade Extrauterine Endometrial Stromal Sarcoma Arising from Peritoneum Endometriosis: A Case Report and Literature Review","volume":"17","author":"Haghighatkhah","year":"2024","journal-title":"Int. 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