Malignant perivascular epithelioid tumor of the vagina: Report of a rare case with brief review of literature
- 1 May 2020
- journal article
- review article
- Published by Wiley in Diagnostic Cytopathology
- Vol. 48 (5), 483-488
- https://doi.org/10.1002/dc.24402
Abstract
Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors with immunohistochemical co-expression of melanocytic and myoid markers. Vaginal PEComas have been described in only nine cases so far. We describe the case of a 65-year-old female with a large growth in the left lateral vaginal wall. Biopsy imprint smears showed dispersed tumor cells with anisonucleosis, multinucleation, and bizarre forms, suggestive of a malignant tumor. Histopathology, however, showed perivascular arrangement of clear epithelioid cells, focal necrosis, intracellular brown pigment in few cells, and mitotic activity at 2 to 3 per 50 high power fields. Immunohistochemical positivity for vimentin, HMB-45, S-100 protein, desmin, and MyoD1 assisted in rendering a final pathological diagnosis of malignant PEComa of the vagina. Further work-up revealed metastatic deposits in liver and retroperitoneal lymph nodes. PEComa arising in vagina is an unusual phenomenon with the malignant variant being an extremely rare tumor. Awareness of the characteristic morphology and utilization of a panel of immunohistochemical stains are mandatory to be able to make a precise diagnosis and appropriate prognostication.This publication has 13 references indexed in Scilit:
- Two cases of perivascular epithelioid cell tumor of the uterus: clinical, radiological and pathological diagnostic challengeEuropean Journal of Medical Research, 2017
- A huge malignant perivascular epithelioid cell tumor (PEComa) of the uterine cervix and vaginaPathology - Research and Practice, 2014
- Perivascular Epithelioid Cell Neoplasm (PEComa) of the Gynecologic TractThe American Journal of Surgical Pathology, 2014
- A 6-year-old girl with vaginal spotting who was diagnosed with perivascular epithelioid cell neoplasm after vaginoscopic resectionObstetrics & Gynecology Science, 2014
- Perivascular Epithelioid Cell TumorArchives of Pathology & Laboratory Medicine, 2009
- A heavily pigmented vaginal perivascular epithelioid cell neoplasmJournal of Obstetrics and Gynaecology, 2009
- Perivascular epithelioid cell tumour of the vagina in an 8 year old girlJournal of Pediatric Surgery, 2007
- Perivascular Epithelioid Cell Tumor (PEComa) in the Genitourinary TractAdvances in Anatomic Pathology, 2007
- Perivascular Epithelioid Cell Neoplasms of Soft Tissue and Gynecologic OriginThe American Journal of Surgical Pathology, 2005
- Perivascular epithelioid tumor of urinary bladder and vaginaAnnals of Diagnostic Pathology, 2005