Gund Gayatri, Chadha Akansha, Dongre Atul, Nayak Chitra
Department of Dermatology, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
Indian Dermatol Online J. 2023 Oct 5;14(6):856-860. doi: 10.4103/idoj.idoj_696_22. eCollection 2023 Nov-Dec.
Vulvar squamous cell carcinoma with sarcomatoid features is an extremely rare histological variant of squamous cell carcinoma with co-existence of both epithelial and mesenchymal features. A 70-year-old woman presented with genital lesions for 4 months with associated burning and pain. Examination revealed well-defined bilaterally symmetrical hyperpigmented plaques on labia majora, fleshy erythematous growth on labia minora. Biopsy from the fleshy mass was suggestive of sarcomatoid malignancy. However, immunohistochemistry was positive for cytokeratin AE1/AE3 and negative for desmin and smooth muscle actin. Biopsy from hyperpigmented plaque was suggestive of Bowens disease. On the basis of histopathology and immunohistochemistry findings, diagnosis of vulvar sarcomatoid squamous cell carcinoma with Bowens disease was made and patient was started on external beam radiation therapy. Sarcomatoid squamous cell carcinoma of vulva is very rare cancer that has an aggressive and fatal course. Diagnosis has traditionally been difficult due to a large ratio of sarcomatous to squamous cell component. Due to its rarity, there are no distinct guidelines to direct therapy and care.
具有肉瘤样特征的外阴鳞状细胞癌是鳞状细胞癌一种极为罕见的组织学变体，同时存在上皮和间充质特征。一名70岁女性出现生殖器病变4个月，伴有烧灼感和疼痛。检查发现双侧大阴唇有边界清晰的对称性色素沉着斑，小阴唇有肉质红斑性肿物。肉质肿物活检提示为肉瘤样恶性肿瘤。然而，免疫组化显示细胞角蛋白AE1/AE3阳性，结蛋白和平滑肌肌动蛋白阴性。色素沉着斑活检提示鲍温病。根据组织病理学和免疫组化结果，诊断为外阴肉瘤样鳞状细胞癌合并鲍温病，患者开始接受外照射放疗。外阴肉瘤样鳞状细胞癌是一种非常罕见的癌症，病程侵袭性强且致命。传统上，由于肉瘤成分与鳞状细胞成分比例较大，诊断困难。由于其罕见性，目前尚无明确的治疗和护理指南。
