BORDERLINE MALIGNANT CHANGE IN RECURRENT MULLERIAN PAPILLOMA OF THE VAGINA

Malignant change occurred in a benign, recurrent vaginal mullerian pol yp. The patient, a 49 year old woman with cerebral palsy, presented wi th a polypoid mass in the vagina. At four years of age she had present ed with a haemorrhagic polyp, and over the following years she had rec urrent irregular bleeding and regrowth of the polypoidal mass, requiri ng a total of 10 operations to excise the polyp. Histological examinat ion of the specimen showed typical mullerian features with tubal, endo metrioid, and endocervical cell types. There were significantly abnorm al nuclei, indicating low grade or borderline malignancy. Review of pr evious biopsies showed similar mullerian features but no atypia. This is the first reported case of borderline malignant change in a previou sly benign recurrent mullerian papilloma of the vagina. Definitive rad ical surgery or radiotherapy is contraindicated in this patient and sh e remains under follow up.