Archives of gynecology and obstetrics · 2010
Sarcomatoid squamous cell carcinoma of the vulva expressing smooth muscle actin and S100 protein.
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Terada Tadashi
Аннотация
INTRODUCTION: Vulvar sarcomatoid squamous cell carcinoma has been rarely reported.
METHODS: Case report and immunohistochemistry.
RESULTS: The author herein reports a peculiar vulvar tumor. An 87-year-old woman with hypertension presented with a vulvar tumor, and admitted to our hospital. Gross examination showed an elevated tumor measuring 3 × 4 × 5 cm in the vulva near the urethra. An excisional biopsy was taken, and it showed proliferation and invasion of malignant spindle cells (70% in area) and malignant polygonal cells (30% in area). There were gradual transitions between vulvar squamous epithelium and these malignant tumor cells. Immunohistochemically, the malignant sarcomatoid cells (spindle and polygonal cells) were positive for cytokeratins, epithelial membrane antigen, vimentin, α-smooth muscle actin, S100 protein, and p53 protein. They were negative for melanosome, CD34, CD68, myoglobin, and CD45. Ki-67 labeling was 63%. A pathological diagnosis of sarcomatoid squamous cell carcinoma expressing smooth muscle antigen and S100 protein was made. The patient developed lung metastasis 2 months later, and suddenly died of unknown cause.
CONCLUSION: A rare case of vulvar sarcomatoid squamous cell carcinoma expressing S100 protein and α-smooth muscle actin is reported.
METHODS: Case report and immunohistochemistry.
RESULTS: The author herein reports a peculiar vulvar tumor. An 87-year-old woman with hypertension presented with a vulvar tumor, and admitted to our hospital. Gross examination showed an elevated tumor measuring 3 × 4 × 5 cm in the vulva near the urethra. An excisional biopsy was taken, and it showed proliferation and invasion of malignant spindle cells (70% in area) and malignant polygonal cells (30% in area). There were gradual transitions between vulvar squamous epithelium and these malignant tumor cells. Immunohistochemically, the malignant sarcomatoid cells (spindle and polygonal cells) were positive for cytokeratins, epithelial membrane antigen, vimentin, α-smooth muscle actin, S100 protein, and p53 protein. They were negative for melanosome, CD34, CD68, myoglobin, and CD45. Ki-67 labeling was 63%. A pathological diagnosis of sarcomatoid squamous cell carcinoma expressing smooth muscle antigen and S100 protein was made. The patient developed lung metastasis 2 months later, and suddenly died of unknown cause.
CONCLUSION: A rare case of vulvar sarcomatoid squamous cell carcinoma expressing S100 protein and α-smooth muscle actin is reported.