He S R, Deng W H, Yang L, Yang K, Cui D, Liu D G
Eur J Gynaecol Oncol. 2017;38(2):296-302.
Primary adenocarcinoma of the vulva is uncommon, and cloacogenic adenocarcinoma of the vulva is extremely rare. Here the authors report a vulvar neoplasm, arising in continuity with the epidermis, characterized by villoglandular architecture, and mucinous-type ep- ithelium with intestinal differentiation (goblet cells). Histochemistry, immunohistochemistry, and gene mutation analysis revealed a colon-like pattern, except for CK7 expression. Extensive workup failed to reveal other primary cancers. In order to provide a much bet- ter experience for diagnosis, the authors compared the previously published cases with the present case regarding clinical presentation and histopathologic aspect. They believe that the notion of the tumor arising from cloacal remnants is a more acceptable viewpoint, and its behavior is mostly indolent. In the present case, a wide local excision was sufficient for radical cure.
原发性外阴腺癌并不常见，而外阴泄殖腔源性腺癌极为罕见。本文作者报告了一例起源于表皮连续性的外阴肿瘤，其特征为绒毛腺管状结构以及具有肠化生（杯状细胞）的黏液型上皮。组织化学、免疫组织化学及基因突变分析显示，除CK7表达外，呈现结肠样模式。全面检查未发现其他原发性癌症。为了提供更好的诊断经验，作者将本病例与既往发表病例的临床表现和组织病理学特征进行了比较。他们认为肿瘤起源于泄殖腔残余的观点更易接受，且其行为大多呈惰性。在本病例中，广泛局部切除足以实现根治。
