Hyaline vascular variant of low-grade endometrial stromal sarcoma masquerading as ovarian tumor

Endometrial stromal sarcomas (ESSs) are uncommon tumors of the uterus, and the cytologic features have only been reported in a number of case reports that mostly discuss the features of higher grade undifferentiated sarcomas. This article discusses the cytologic features of a unique case of hyaline vascular variant of low-grade ESSs (LGESS), which masqueraded as a ovarian tumor due to its massive extension into broad ligament. Touch imprint smears revealed bland cells occurring singly and small clusters, scant cytoplasm, small round or oval nuclei, fine chromatin pattern, and occasional small prominent nucleoli. Frequent metachromatic hyaline globules and plaques were seen between the tumor cells in all the smears. Histological examination of the tumor showed LGESS with extensive stromal and perivascular hyalinization