Leiomyosarcoma of the vulva - A case report

BACKGROUND: Leiomyosarcoma of the vulva is a rare mesenchymal tumor. Biolog ic features of a low grade tumor were investigated by an immunohistochemica l workup. CASE: A 38-year-old woman presented with a slowly growing vulvar mass. Surg ical treatment was performed, and a low grade leiomyosarcoma of the vulva w as diagnosed. Immunohistochemical reactions were performed with monoclonal antibodies against desmin, vimentin, smooth muscle actin, cytokeratin, S-10 0 protein, estrogen, progesterone and androgen receptor, p53 protein, Ki-67 antigen, leukocyte common antigen and polyclonal antibodies to factor VIII -related antigen. Expression of estrogen, progesterone and androgen recepto r was present in addition to a moderate number of Ki-67-positive cells and absence of p53 protein overexpression and lymphatic cell infiltration besid es adequate microvessel density for smooth muscle tumors. Since the immunoh istochemical markers indicated a less aggressive tumor, any further adjuvan t therapy was rejected. The patient was without recurrence 24 months later. CONCLUSION: The immunohistologic profile proved the low histologic grade of vulvar leiomyosarcoma. The findings helped to estimate prognosis and plan therapy.