Rare Metastatic Involvement of the Sigmoid Mesocolon by Low-Grade Endometrial Stromal Sarcoma.

INTRODUCTION: Endometrial stromal sarcoma (ESS) is an uncommon uterine malignancy with an indolent course and potential for late recurrence or metastasis. Extrauterine ESS is exceedingly rare, especially in the absence of a primary uterine lesion. CASE PRESENTATION: We present a case of a 50-year-old woman with low-grade ESS metastasizing to the sigmoid mesocolon. The patient underwent surgical resection followed by radical hysterectomy, bilateral salpingo-oophorectomy, and hormonal therapy with letrozole. After 5 years of follow-up, she remains disease-free. DISCUSSION: This case underscores the importance of considering ESS in the differential diagnosis of mesocolon masses and highlights the role of combined surgical and hormonal therapy in achieving long-term remission.