Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Obstet Gynaecol Res. 2024 Dec;50(12):2372-2376. doi: 10.1111/jog.16139. Epub 2024 Nov 5.
Malignant peripheral nerve sheath tumors (MPNSTs) of the cervix are rare, particularly in patients with neurofibromatosis type 1 (NF1). This report describes a cervical MPNST in an 18-year-old patient with no history of sexual activity, abnormal vaginal discharge, and prolonged menstruation. She had more than six café-au-lait spots on her body since birth and was diagnosed with NF1 at 2 years of age. Positron emission tomography-computed tomography revealed a large pelvic mass and lung and bone metastases. Biopsy confirmed MPNST. Immunohistochemical staining showed diffuse positivity for CD10, approximately 30% positivity for cyclin D1, partial positivity for α-SMA, desmin, and MyoD1, and negativity for myogenin, S-100, and SOX-10. A cancer gene panel identified several genetic abnormalities, but none were actionable mutations. Despite systemic chemotherapy, the tumor progressed rapidly, and the patient died 8 weeks post-admission. Early diagnosis of MPNST is crucial. In patients with NF1, even mild symptoms can indicate MPNST.
宫颈恶性外周神经鞘瘤(MPNST)较为罕见,尤其在 1 型神经纤维瘤病(NF1)患者中更为少见。本报告描述了一位 18 岁患者的宫颈 MPNST 病例,该患者无性生活史、无异常阴道分泌物、经期延长。她出生时身上就有超过 6 处咖啡牛奶斑,2 岁时被诊断为 NF1。正电子发射断层扫描-计算机断层扫描显示盆腔内有一个大肿块,肺部和骨骼有转移。活检证实为 MPNST。免疫组化染色显示 CD10 弥漫阳性,cyclin D1 约 30%阳性,α-SMA、结蛋白和 MyoD1 部分阳性,肌球蛋白、S-100 和 SOX-10 阴性。癌症基因panel 检测到几种基因异常,但均非可用药突变。尽管进行了全身化疗,肿瘤仍迅速进展,患者入院后 8 周死亡。早期诊断 MPNST 至关重要。在 NF1 患者中,即使是轻微的症状也可能提示 MPNST。