Investigations
The initial pathologic
consideration of a recurrent tumor was a malignant nerve sheath tumor of
the vulva. Due to this tumor’s rarity in the vulva, the case was
presented at the International Gynecologic Cancer Society monthly
videoconference with collaboration from multiple international
sub-specialists and pathologists. It was established that the primary
and recurrent tumors exhibited similar morphology and presented as a
high-cellular spindle cell neoplasm (Figure 1 a,b,c,d).
Immunohistochemistry showed tumor cells stained positive for SMA,
calponin, and CD10. Negative for desmin, h-caldesmon, CD117, CD34,
HMB-45, BCL-2, cytokeratin, EMA, and p63. CD68 highlighted
multinucleated macrophages.