Primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old woman: a case report

<p>Abstract</p> <p>Introduction</p> <p>Primary Ewing's sarcoma or primitive neuroectodermal tumor of the genital tract of women is uncommon. Rarer still is its occurrence in the vagina, with only five cases described so far. Out of these, only one case was confirmed using molecular analysis.</p> <p>Case presentation</p> <p>We present an extremely rare case of Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old Indian girl. She presented with a vaginal mass that was initially diagnosed as a malignant round cell tumor. Immunohistochemistry showed diffuse positivity for vimentin, membranous positivity for MIC2, and positivity for BCL2 and FLI-1. On the other hand, she was negative for cytokeratin, epithelial membrane antigen, desmin, Myo D-1, myogenin and smooth muscle actin. A diagnosis of primitive neuroectodermal tumor was thus offered. Furthermore, a molecular analysis of our patient using reverse transcription-polymerase chain reaction technique showed positivity for t(11; 22) (q24; q12) (EWSR1-FLI1), thus confirming the diagnosis of a Ewing's sarcoma/primitive neuroectodermal tumor. Our patient was offered chemotherapy on Institutional protocol EFT 2001.</p> <p>Conclusion</p> <p>This is a rare case of primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor, which was confirmed with molecular analysis, in the youngest patient known so far. This study reinforces the value of integrating morphological features with membranous MIC2 positivity, along with application of molecular techniques in objective identification of an Ewing's sarcoma or primitive neuroectodermal tumor at uncommon sites.</p

Original Article - Classification of thymic neoplasms: Observations on the WHO 1999 classification based on 56 cases

Background: The World Health Organization (WHO), in 1999, laid down histological criteria for thymoma sub-classification (Type A, AB, B1, B2, B3 and C). This study aims to assess the ease of application of this classification and to evaluate any relationship with the clinical stage. Material and Methods: A total number of 56 cases from the Tata Memorial Hospital, Mumbai were studied. Results: The age of the patients ranged from 17 to 71 years (mean 48.6 years) and the male to female ratio was 3:1. The number of cases in each of the WHO tumour types were Type A-10, Type AB-20, Type B1-6, Type B2-11, Type B3-3, and Type C-6 cases. Invasive tumours were seen in 25%, 23%, 75%, 60%, 100% and 100% of Type A, AB, B1, B2, B3 and C tumours, respectively. Conclusion: It can be concluded that the WHO Classification is histologically reproducible and there is a good correlation between the WHO subtypes and tumour invasiveness

Intraosseous myoepithelioma: A rare, distinct tumor entity

Primary musculoskeletal myoepithelial tumors (METs) are distinctly rare tumors and are being increasingly recognized as a result of improved diagnostic criteria and objective confirmation with immunohistochemical markers, including epithelial markers. Recent studies have unraveled distinct molecular mechanisms underlying these tumors. Herein, we present our second diagnosed case of an intraosseous MET that occurred in the tibia of a 37-year-old lady. The case is discussed with regards to current clinicopathological perspectives on these rather uncommon tumors, including our personal experience