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ESS Hormonal Therapy — SCE Medical Oncology MCQ

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ModerateGynaecological CancersESS Hormonal TherapySCE Medical Oncology

A 55-year-old woman is diagnosed with a low-grade endometrial stromal sarcoma (ESS). Molecular testing confirms a JAZF1-SUZ12 fusion. What is the role of hormonal therapy in ESS?

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Correct answer: D — Hormonal therapy (aromatase inhibitors, medroxyprogesterone acetate) is effective for low-grade ESS because these tumours express oestrogen and progesterone receptors — hormonal therapy is used adjuvantly and for metastatic disease

Low-grade endometrial stromal sarcoma (ESS) is an ER/PR-positive mesenchymal tumour characterised by specific translocations (JAZF1-SUZ12 most common). It responds to hormonal manipulation: aromatase inhibitors (letrozole, anastrozole), medroxyprogesterone acetate, and GnRH agonists are effective both as adjuvant therapy and for advanced/recurrent disease. Tamoxifen is CONTRAINDICATED (oestrogenic effect on uterine stroma). Bilateral salpingo-oophorectomy provides surgical hormone deprivation. Prognosis is generally favourable even with recurrence.

Reference: ESMO 2024 Uterine Sarcoma; NICE NG