Primary vaginal Ewing’s sarcoma/primitive neuroectodermal tumour: diagnostic and treatment challenges

Extra osseous Ewing’s sarcoma/primitive neuroectodermal tumour (PNET) of the genital tract of women is scarcely\ud described in the literature and involvement of the vagina is even rarer with a very few cases reported so far. We present\ud 50-year-old-woman who presented with a vaginal mass that was diagnosed to be a malignant round cell tumour which\ud later was confirmed to be primary vaginal Ewing’s sarcoma/ PNET on light microscopy and immunohistochemical\ud staining. She was then treated with induction chemotherapy followed by local radiotherapy and further maintenance\ud chemotherapy. This rare case of primary vaginal Ewing’s sarcoma/PNET emphasizes the need for combining\ud morphological features with immunohistochemistry with a panel of antibodies in establishing the diagnosis of Ewing’s\ud sarcoma/PNET at an uncommon site. Further, the case also highlights the use of induction chemotherapy followed by\ud radiation therapy and subsequent maintenance chemotherapy as a treatment modality

A rare case of vaginal sarcoma in pregnancy

Vaginal Sarcoma is an extremely rare tumour in pregnancy. Authors are presenting a case report of a pregnant woman who presented with vaginal mass and urinary retention at 32 weeks of gestational age. USG confirmed a live baby with possibility of cervical fibroid. Before further investigations for diagnosis of the mass her emergency LSCS has to be done. Histopathology and immunohistochemistry then confirmed sarcoma

Sarcoma botryoides in a 14 year old girl: a rare case

Embryonal rhabdomyosarcoma (Sarcoma botryoides) of the uterine cervix is an uncommon entity. Because of extreme rarity its discussion has mainly been in the light of individual case reports. We report a case of a 14-year old female who presented with irregular vaginal bleeding and cervical polyp. Her biopsy specimen confirmed sarcoma botryoides and she underwent abdominal hysterectomy with wide excision of vaginal cuff after a multidisciplinary consultation

Don't cancel the surgery just yet! A case report of positive preoperative pregnancy test due to a soft tissue sarcoma production of ectopic beta human chorionic gonadotropin.

Soft tissue sarcomas are a rare group of mesenchymal malignancies which can range from low to high grade. These tumors have different clinical, radiographic, and histopathological characteristics. Beta human chorionic gonadotropin is a naturally secreted hormone by placental syncytiotrophoblast cells during pregnancy. On very rare occasions, sarcomas can develop the ability to ectopically produce human chorionic gonadotropin. Very few cases exist in the literature of soft tissue sarcomas expressing this hormone. We report the case of a 55-year-old female who presented with a posterior thigh soft tissue sarcoma who on the day of surgical resection was found to have an unusually elevated serum human chorionic gonadotropin. Positive immunohistochemical staining of the resected mass confirmed the sarcoma as the source of the beta human chorionic gonadotropin

Association of endometrioid ovarian carcinoma arising from endometriosis, endometrioid endometrial carcinoma, and high-grade undifferentiated endometrial sarcoma. a case report

Endometriosis is a chronic disease that affects women of reproductive age. Malignant transformation in endometriosis is considered to be an unusual event, only occurring in 0.7-0.1% of cases. However the association between endometriosis and endometrial cancer is not well defined. Also in literature, rare cases of uterine sarcoma, about 3% of all uterine malignancies, associated with endometriosis have been reported. The authors report a case of a 47-years-old Italian woman with histologic diagnosis of endometrioid ovarian carcinoma arising from endometriosis, endometrioid endometrial carcinoma, and undifferentiated endometrial sarcoma. Therefore there have been few studies addressing the relationship between endometrial stromal sarcomas (ESS), and endometriosis. Novel scientific findings are necessary to investigate a possible common pathway and an effective treatment, although complete tumor resection can reduce the recurrence rate

Non-Hodgkin’s Lymphoma of the Uterine Cervix

Non Hodgkin’s Lymphoma (NHL) causes many deaths worldwide and its incidence is increasing. They occur commonly in middle aged and elderly people and are disseminated at diagnosis. We present an interesting case of NHL in a 52 years old female, who presented with past a history of postmenopausal bleeding. A 3 x 5 cms endocervical polyp was noticed in the cervix. Biopsy of the polyp revealed it to be a CD20-positive diffuse large B-cell (DLBCL)-type NHL. She was diagnosed as stage IE after staging work-up. She attained a complete response, and has been in remission for 1 year 8 months

Evaluation of Overall Survival (OS) and Event-Free Survival (EFS) of paediatric sarcoma patients at a single institution

Aims: To evaluate OS and EFS of paediatric sarcoma patients with an interest in comparing metastatic cases with non-metastatic cases, and compiling statistics on treatment methods. Methods: Information was obtained from patient notes in the Schiehallion ward. These contained information about diagnosis, treatment, prognostic indicators, and outcomes for each patient. Results: 56 patients, 2001-2008. Osteosarcoma: 11 patients, 7♂, 4♀; age range: 4-16; = 10; OS = 64%, EFS = 55%; Primary site of disease: Femur (47%), Tibia (41%), Humerus (5.5%), Scapula (5.5%), Other (1%); Metastatic Rate = 27% (OS = 0%). Ewing’s sarcoma: 24 patients, 10♂, 14♀; age range: 1-16, = 12; OS = 71%, EFS = 58%; Primary site of disease: Pelvis (29%), Femur (22%), Paraspinal (16%), Chest Wall (10%), Tibia (10%), Other (13%); Metastatic Rate = 21% (OS = 40%; EFS = 40%); Alveolar rhabdomyosarcoma: 10 patients; OS= 80%, EFS = 60%; Metastatic Rate = 20% (OS = 100%; EFS = 100%). Embryonal rhabdomyosarcoma: 11 patients; OS = 73%, EFS = 73%; Metastatic Rate = 0%. Conclusions: Our results reflect access to an experienced and innovative paediatric sarcoma service with close links to a national Sarcoma MDT. The data falls in line with other studies in terms of age of onset, location of primary tumour, metastatic rate, site of metastases, and prognosis for all cancer types. Limb salvage surgery is greatly favoured over amputation for both osteosarcoma and Ewing’s sarcoma. Females have a more favourable prognosis in osteosarcoma and a slightly poorer prognosis in Ewing’s sarcoma. Yorkhill’s overall survival rates are currently better than the UK-wide statistic for three of the four tumours examined.</p

Sarcoma of the Vagina.

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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

A rare diagnosis with a common presentation: a case report on uterine sarcoma

Uterine sarcomas are rare soft tissue tumors which constitute 3% to 7% of overall uterine malignancies. Endometrial stromal sarcoma (ESS) is a rare type of uterine sarcoma arising from the mesodermal component of the body of the uterus. It constitutes around 0.2% of all the uterine tumors. It primarily occurs in perimenopausal women. One third of cases are seen in postmenopausal women. The presentation is not very different from an abnormal uterine bleeding, abdominal pain or a mass effect. Here we discuss an interesting case of 70 years female with a very common presentation of utero-vaginal prolapse but turned out to be a very rare postoperative diagnosis of uterine sarcoma