Malignant schwannoma of the vulva
Introduction
Introduction to vulvar malignant schwannomas Vulvar malignant schwannomas are highly malignant tumors derived from Schwann cells, nerve cells or neuronal cells, and are susceptible to local recurrence and distant metastasis. Occurring in the outer cathode is rare, common in limbs. basic knowledge The proportion of illness: 0.02% - 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: neurofibromatosis
Cause
The cause of vulvar malignant schwannoma
(1) Causes of the disease
Some scholars believe that the onset of vulvar malignant schwannomas is related to the loss of heterozygosity on chromosome 17, the mutation or loss of the tumor suppressor genes p53 and NF1 genes, and the increase in ras gene activity leads to the disease. Thomas et al. Exposure to higher concentrations of nerve growth factor can worsen the course of the disease, and beta-estradiol promotes the disease.
(two) pathogenesis
The tumor is a single spherical, oval, nodular, lobulated or irregular mass with a hard texture, clear boundaries, no capsule or incomplete capsule, grayish white cut surface, fish-like, may be associated with hemorrhagic necrosis .
Microscopic examination showed spiral cells or clusters of spindle-shaped cells. The cytoplasm was rich, the nucleus was large and deeply stained, the twist was corrugated, the atypia was obvious, the mitotic figures were many, and the cells were distributed in dense and sparse areas. Lee 1997) can be spindle-free cells, only the "epithelial-like morphology" cells are arranged in a patch, polygonal, nuclear moderately shaped with eosinophilic cytoplasm, some tumor cells around thick-walled blood vessels, and a few cases contain heterogeneity Genes such as cartilage and bone-like tissue were observed. Under the electron microscope, interlaced cell processes, focal basement membrane and collagen fiber bundle were observed.
Most of the immunohistochemical examinations were positive for S-100, and some were positive for NSE and MBP positive.
Prevention
Vulvar schwannoma prevention
Try to find early, cure early, and do follow-up work.
Complication
Vulvar schwannoma complications Complications neurofibromatosis
Accompanied by systemic multiple neurofibromatosis.
Symptom
Symptoms of vulvar schwannoma common symptoms loss of appetite, defecation, weight loss, dysuria, vaginal mass, painful intercourse, pain
Vulvar malignant schwannomas appear as gradual growth of mass, rapid growth is often accompanied by pain, can not walk, the mass is hard and tender, the size of 2.5 ~ 12cm, mostly occurred in the labia majora, also found in the labia minora, haze , clitoris and perianal, located in the labia majora often have clothing irritation, pain in the labia minora, and often accompanied by pain in the perianal pain, occasionally accompanied by dysuria, loss of appetite and weight loss.
Examine
Examination of vulvar malignant schwannomas
Immunohistochemical detection, p53 tumor suppressor gene detection.
Histopathological examination.
Diagnosis
Diagnosis and differentiation of vulvar malignant schwannomas
Diagnosis can be made based on histopathological examination and clinical presentation.
1. Identification of benign tumors with vulvar soft tissue such as: vulvar lipoma, vulvar fibroids, vulvar leiomyomas, vulvar granulosa cell myeloma.
2. Identification with vulvar cancer such as: vulvar squamous cell carcinoma, vulvar basal cell carcinoma, vulvar adenocarcinoma, etc.
