[Low-grade sarcoma of the endometrial stroma: late recurrence with ureteral and bladder involvement].

Objective: To report a new case of low grade endometrial stroma sarcoma late relapse involving bladder wall and ureter.

Methods: We report the case of a 64 year old female with history of Wertheim-Meigs hysterectomy 30 years before for uterine sarcomatous tumour, who presented with intermittent macroscopic haematuria episodes associated with mild elevation of serum creatinine. Image diagnostic tests--mainly CT-scan--evidenced a right pelvic mass involving the bladder wall and the homolateral distal ureter. Different lines of palliative treatment--chemotherapy and radiotherapy--were started.

Results: Histologic and immunohistochemical studies of samples obtained by transvaginal ultrasound guided biopsies were consistent with low grade endometrial stroma sarcoma. Results from palliative treatment were discouraging.

Conclusions: This type of neoplasms are rare, although relapses may appear after extremely long silent periods. They have potential to compromise urological structures. Although there are publications reporting good results, the role of different palliative therapeutic alternatives is not well established yet, and responses in cases like ours are minimal or none.