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Journal of Medical Case Reports

, 4:88

First Online: 17 March 2010Received: 23 October 2009Accepted: 17 March 2010DOI: 10.1186-1752-1947-4-88

Cite this article as: Rekhi, B., Qureshi, S., Basak, R. et al. J Med Case Reports 2010 4: 88. doi:10.1186-1752-1947-4-88

Abstract

IntroductionPrimary Ewing-s sarcoma or primitive neuroectodermal tumor of the genital tract of women is uncommon. Rarer still is its occurrence in the vagina, with only five cases described so far. Out of these, only one case was confirmed using molecular analysis.

Case presentationWe present an extremely rare case of Ewing-s sarcoma or primitive neuroectodermal tumor in a 17-year-old Indian girl. She presented with a vaginal mass that was initially diagnosed as a malignant round cell tumor. Immunohistochemistry showed diffuse positivity for vimentin, membranous positivity for MIC2, and positivity for BCL2 and FLI-1. On the other hand, she was negative for cytokeratin, epithelial membrane antigen, desmin, Myo D-1, myogenin and smooth muscle actin. A diagnosis of primitive neuroectodermal tumor was thus offered. Furthermore, a molecular analysis of our patient using reverse transcription-polymerase chain reaction technique showed positivity for t11; 22 q24; q12 EWSR1-FLI1, thus confirming the diagnosis of a Ewing-s sarcoma-primitive neuroectodermal tumor. Our patient was offered chemotherapy on Institutional protocol EFT 2001.

ConclusionThis is a rare case of primary vaginal Ewing-s sarcoma or primitive neuroectodermal tumor, which was confirmed with molecular analysis, in the youngest patient known so far. This study reinforces the value of integrating morphological features with membranous MIC2 positivity, along with application of molecular techniques in objective identification of an Ewing-s sarcoma or primitive neuroectodermal tumor at uncommon sites.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-4-88 contains supplementary material, which is available to authorized users.

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Autor: Bharat Rekhi - Sajid Qureshi - Ranjan Basak - Sangeeta B Desai - Seema Medhi - Purna Kurkure - Santosh Menon - Amita Mahe

Fuente: https://link.springer.com/







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