Osteoclastic giant cell rich undifferentiated Pleomorphic sarcoma of the vulva- A rare case report

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Author: 
Dr. Sunil Kumar Mahto, Dr. Anu Singh, Dr. Arvind Kumar, Dr. Srivastava, A. K., Dr. Sinha, A. K. and Dr. Paswan Manoj
Subject Area: 
Health Sciences
Abstract: 

Background: Undiffrentiated pleomorphic sarcoma of vulva with osteoclastic giant cells is a diagnosis of exclusion. It is an exceptionally uncommon diagnostic finding which was eventually diagnosed in our institute and this required a methodical clinical approach and extensive immunohistochemical markers to rule out other probable diagnostic possibilities at this site. The quick diagnostic approach at our institute was ensued by operation. Case Report: 53 years old female presented with vulval growth to our institute. Incision biopsy was performed as a routine procedure. Biopsy showed atypical spindle cells with few cells showing rhabdoid morphology and osteoclast like giant cells were also present. Histological findings with aid of immunohistochemistry led to the diagnosis of undifferentiated pleomorphic sarcoma with osteoclast like giant cells. The tumor cells stained intensely for vimentin (a mesenchymal marker), but no immunoreactivity for the Cytokeratin Pan (epithelial cells marker), Leukocyte Common Antigen (lymphoid cells marker), SMA (smooth muscle actin), Desmin (smooth and striated muscular cells marker), S100 (neuronal cells marker), CD34 (to identify vascular tumor), CD99 (synovial sarcoma marker) was detected. Conclusion: Undifferentiated pleomorphic sarcoma of the vulva is an uncommon mesenchymal neoplasm that presents diagnostic challenges. Therefore, as with all rare tumors, undifferentiated pleomorphic sarcoma should be managed in reference centers to determine whether treatment of choice is surgical excision or some form of adjuvant therapy can have beneficial effects.

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