Soft-tissue sarcoma of the vagina and vulva: a clinicopathologic study

To review the clinicopathologic characteristics of vulvovaginal soft-tissue sarcomas, and to correlate these variables with response to treatment.

We performed a retrospective review of the records of 24 women treated at Memorial Hospital for sarcoma of either the vulva or vagina over 20 years (1974-1993). Archival pathology specimens were reviewed to confirm the diagnosis, histology, and grade of the tumor.

Fifteen patients had sarcomas arising from the vagina and nine had primary vulvar tumors. Leiomyosarcoma was the most common histology (n = 13). Twenty-three of 24 women underwent surgical excision as their primary therapy. Twenty-three were available for follow-up, and 16 of them (70%) are free of disease at a median follow-up time of 47 months (range 12-156, mean 59). Five women died of progressive disease and two are currently alive with persistent or recurrent disease. Grade was the most important predictor of outcome; all seven women with low-grade tumors are alive without evidence of disease.

Soft-tissue sarcomas are rare tumors of the lower genital tract. The primary therapy is surgical; adjuvant radiation therapy is indicated for high-grade tumors and locally recurrent low-grade sarcomas.