ESS in the vagina
- Dr John Maksem
- Sep 22, 2017
- 1 min read
ER
PR
CD 10
BCL2
Calponin
EMA in an area of endometriosis
Dear Elvio, For your files: 27 y/o female with 45 gram, 4.9 x 3.6 x 3.3 cm low grade endometrial stromal sarcoma. Apparently, only 5 prior cases in the literature at this site.
My sign out:
VAGINAL MASS:
LOW-GRADE ENDOMETRIAL STROMAL SARCOMA.
ISOLATED FOCUS OF VASCULAR INVASION IDENTIFIED (BLOCK 1E).
ISOLATED GLAND FOCUS SUGGESTING ASSOCIATION WITH ENDOMETRIOSIS IDENTIFIED (BLOCK F); SEE COMMENT.
TUMOR IMMUNOHISTOCHEMISTRY;
POSITIVE IHC-STAINS; BCL2, FOCAL CALPONIN, STRONG CD10, WEAK CD99, STRONG VIMENTIN, 100% NUCLEAR STAINING FOR ER-ALPHA-EP1 AND PR.
NEGATIVE OR NORMAL TISSUE PATTERN IHC-STAINS: CD117, CYCLIN D1, DESMIN, EMA, HMB45, CYTOPLASMIC INHIBIN.
COMMENT:
Negative IHC-stains exclude YWHAE-FAM22 high grade endometrial stromal sarcoma, synovial sarcoma, highly cellular leiomyoma, GIST, and PECom
Cases of primary ESS in extrauterine locations have been widely reported. The sites of occurrence include pelvic cavity, ovary, abdominal cavity, fallopian tube, retroperitoneum, vulva, and vagina. Of these extrauterine sites, the vagina is an extremely rare site. Only 4 cases of extrauterine ESS arising in vagina were reported in the literature up to the date of the attached reference. Four of them had no detectable association of endometriosis; however, foci of endometriosis are generally found in the vicinity of the neoplasm in the majority of extrauterine ESS cases, and the presence of endometriosis could explain the occurrence of these tumors in extrauterine sites. In this case, the presence of primary uterine tumor needs to be clinically addressed. (Ref: Int J Clin Exp Pathol. 2013; 6(12): 2997–3002.)
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