Endometrial stromal sarcoma presenting as large bleeding left upper quadrant mass

Endometrial stromal sarcoma (ESS) represents only 0.2% of all uterine malignancies. Even fewercases have been reported on patients presenting with symptomatic disease. We report the case of young ladypresenting with a large bleeding abdominal mass. At the time of surgery, an en bloc excision of the masswith a partial pancreatectomy, splenectomy, transverse colectomy, left nephrectomy, left adrenalectomy andresection of the diaphragm was performed. The final pathology revealed a malignant spindle and epithelialcell neoplasm with features favoring a variant of ESS. ESS can present in an atypical fashion as an intraabdominalmass; a multi-disciplinary treatment approach for patients with this disease is crucial.