Primary Carcinosarcoma of the Vagina Associated With Differentiated Squamous Intraepithelial Neoplasia in a Patient With Complete Uterine Prolapse: Case Report and Review of the Literature

Abstract

Vaginal carcinosarcomas (VCSs) are rare and clinically aggressive neoplasms. Primary vaginal malignancies are among the rarest malignant tumors, so clear management guidelines and optimal therapy, especially in the presence of significant pelvic organ prolapse, has not been determined. Here, we present a case of primary VCS closely associated with differentiated squamous intraepithelial neoplasia (DSIN), from which it appeared to have arisen in a postmenopausal patient with complete uterine prolapse. The unusual presentation of our case with DSIN in the adjacent vaginal epithelium with possible diagnostic pitfalls emphasizes the need for systemic presentation of these cases to help pathologists and clinicians know that such lesions can initially present in a patient with complete uterine prolapse. To our knowledge, this is the first case of vaginal DSIN described in the literature to date.

Trichoblastic Carcinosarcoma Arising From the Vagina: A Case Report With Comprehensive Immunophenotypic Analysis

“…Primary vaginal carcinosarcomas are even less reported, with only 13 cases documented in the literature. 1,2 Cutaneous carcinosarcomas, defined by the presence of an epidermal or adnexal carcinomatous component, are equally rare entities. 3 To date, only 5 cases of trichoblastic carcinosarcoma have been reported, 4 which all are of cutaneous primary.…”

Two Components of Variant Profiles in Primary Vaginal Carcinosarcoma via Next-Generation Sequencing and a Literature Review

“…VCS is an extremely rare and highly aggressive tumor consisting of admixed malignant epithelial and mesenchymal elements. 2 In each analysis on both components of our case, VCS was shown to be monoclonal in origin, similar to other malignant mixed Müllerian tumors, and contained some mutations frequently found in uterine carcinosarcoma (UCS) or uterine serous carcinoma (USC). 6 A recent analysis shows that the proportion of UCS in primary endometrial carcinomas in the United States, between 1973 and 2013, has been significantly increasing from 1.7% to 5.6%.…”

“…Management of the few reported cases has inevitably been inconsistent and the prognosis is very poor because of the tendency for early and widespread metastases. 2…”

“…Management of the few reported cases has inevitably been inconsistent and the prognosis is very poor because of the tendency for early and widespread metastases. 2 Recent mutational studies of uterine carcinosarcoma show that integrated genomic characterization reveals a range of information regarding cancer-related genes. 3 However, the genetic basis of these rare tumors has not been explored.…”

Sarcomas of the lower female genital tract (vulva, vagina, and cervix): literature review and own cases

“…Карциносаркома влагалища, также известная как злокачественная смешанная мюллерова опухоль, встречается также крайне редко, обычно на 6-м и 8-м десятилетиях жизни, и морфологически содержит как эпителиальный, так и мезенхимальный компоненты [42,43]. К настоящему времени в литературе описаны отдаленные результаты лечения лишь 14 случаев карциносарком влагалища, при этом опухоль характеризовалась агрессивным течением.…”