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Vaginal high-grade sarcoma in pregnancy.

P Akametalu1, J M Barcelon1, O Myint2

  • 1University of California Los Angeles, Division of Gynecologic Oncology, Los Angeles, CA, USA.

Gynecologic Oncology Reports
|December 20, 2021
PubMed
Summary

This case report highlights the challenges of diagnosing and treating vaginal sarcoma in pregnant patients. Postpartum resection and brachytherapy were used for residual disease, emphasizing the need for further research.

Keywords:
PregnancyRadiationVaginal sarcoma

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Area of Science:

  • Gynecologic Oncology
  • Obstetrics
  • Surgical Pathology

Background:

  • Vaginal cancer is a rare malignancy, accounting for 1-2% of female genital tract cancers.
  • Vaginal sarcomas are rare, with leiomyosarcomas being the most common type.
  • Limited data exists for treating vaginal sarcomas, especially during pregnancy.

Observation:

  • A 31-year-old pregnant patient presented with vaginal bleeding and expelled an 11 cm mass.
  • Pathology confirmed a high-grade gynecologic sarcoma.
  • Postpartum, a 1 cm vaginal lesion was resected and diagnosed as vaginal sarcoma.

Findings:

  • Cesarean section was performed at 36 weeks gestation; uterine pathology was negative for sarcoma.
  • Surgical resection of the residual vaginal lesion achieved negative margins.
  • Adjuvant vaginal brachytherapy was administered for the postpartum vaginal sarcoma.

Implications:

  • Accurate pathological diagnosis of vaginal sarcoma during pregnancy presents challenges.
  • Surgical resection with negative margins is crucial for managing vaginal sarcoma.
  • Further research is needed on optimal delivery timing and adjuvant treatment for pregnancy-associated vaginal sarcomas.