Primary vaginal leiomyosarcoma: A case report with complete morphological, immunohistochemical and ultrastructural...

Area of Science:

• Gynecologic Oncology
• Surgical Pathology

Background:

• Primary vaginal leiomyosarcomas (LMS) are rare, with unknown causes and poor prognosis.
• There is a lack of established management guidelines for vaginal LMS.

Observation:

• A 58-year-old woman presented with a 25 × 23 × 28 mm vaginal mass infiltrating the urethra.
• Biopsy confirmed LMS, positive for vimentin, alpha-smooth muscle actin, caldesmon, desmin, p16, and p53.
• Anterior pelvic exenteration was performed, with diagnosis confirmed by microscopy and electron microscopy.

Findings:

• Complete surgical resection with wide, clear margins is crucial for optimal outcomes in vaginal LMS.
• Histopathological confirmation via biopsy, immunohistochemistry, and electron microscopy is vital for accurate diagnosis.

Implications:

• This case highlights the importance of early detection and aggressive surgical management for vaginal LMS.
• Accurate diagnosis through advanced techniques aids in selecting the appropriate treatment strategy for rare mesenchymal tumors.