Ewing sarcoma of the vulva

Introduction

Introduction to vulvar Ewing's sarcoma Vulvar Ewing sarcoma (peripheral primitive neuroectodermal tumor) has been studied in recent years from immunohistochemistry, electron microscopy, cell culture, and molecular biology. It has been found that Ewing's sarcoma is a primitive neuroectodermal-tumor. basic knowledge The proportion of illness: 0.008% Susceptible people: women Mode of infection: non-infectious Complications: lipoma

Cause

Causes of vulvar Ewing sarcoma

(1) Causes of the disease

Vulvar Ewing sarcoma/peripheral primitive neuroectodermal tumor is a primitive tumor derived from neural crest.

(two) pathogenesis

The tumor is lobulated, with clear boundaries, gray-white cut surface, crisp and elastic, and visible bleeding, necrosis and cystic changes in the center.

Microscopic examination (25%):

Microscopic examination showed a small circular cell nested in a uniform size, arranged closely, with unclear cell boundaries, few cytoplasm, round nucleus, chromatin granules, small nucleoli and not clear, mitotic figures visible, 1~ 3/10HPF, some may be associated with focal Homer-Wright (HW) chrysanthemum or rosette-like structure, less interstitial, no reticular fibers, tumor cell cytoplasmic PAS positive, not resistant to amylase digestion, electron microscopy See undifferentiated mesenchymal cells, nuclear chromatin is evenly distributed, see glycogen accumulation, and some visible neuroendocrine granules.

Cell O13 (HBA71 antigen; P30/32, MIC2) positive, vimentin, CD99 positive, neuron specific enolase (NSE), synaptophysin (SY38), chromogranin (CgA), keratin fraction Positive.

Gene sequencing (18%):

All Ewing sarcomas have a rearrangement of the EWS gene, and about 95% of Ewing's sarcoma has a specific EWS/FL1-1 chimeric gene due to chromosomal translocation-t(11;22)(q24;q12). A small number of EWS/ERG chimeric genes with t(21;22)(q21;q12), whether using reverse transcription polymerase chain reaction (RT-PCR) to detect EWS/FLI-1 transcription or Fluorescence in situ hybridization (FISH) detection of EWS gene rearrangement can assist in the diagnosis.

Prevention

Vulvar Ewing sarcoma prevention

1. Regular physical examination, early detection, early treatment, and good follow-up.

2. Fasting hair: such as fish, shrimp, crab, chicken head, pig's head meat, goose meat, chicken wings, chicken feet, etc., will increase the itching and inflammation of the genital area after eating.

3. Try to eat less spicy and stimulating foods such as onions, peppers, peppers, peppers, mustard, and fennel.

4. Avoid eating fried, greasy foods: such as fritters, butter, butter, chocolate, etc. These foods help to moisturize and increase the amount of vaginal discharge, which is not conducive to the treatment of the disease.

5. Quit smoking and alcohol: Tobacco and alcohol are very irritating and will aggravate inflammation.

Complication

Vulvar Ewing sarcoma complications Complications

The vulva Ewing sarcoma is rare, with an onset age of 10 to 45 years and a median age of 23 years. In recent years, from the perspective of immunohistochemistry, electron microscopy, cell culture and molecular biology, Ewing's sarcoma is a kind of primitive neuroectodermal-tumor. Therefore, it is also called peripheral primitive neuroectodermal tumor. Advanced tumor metastasis.

Symptom

Vulvar Ewing sarcoma symptoms Common symptoms Vulvar swelling Vulvar pain Vulvar tenderness

Mainly manifested as a slow growth of the vulva, activity, tenderness and fluctuation, size 0.5 ~ 4cm, often misdiagnosed as lipoma or Pap sac cyst before surgery.

Examine

Examination of vulvar Ewing sarcoma

Laboratory examination: tumor marker examination, tumor molecular marker detection.

Other auxiliary examinations: histopathological examination.

Tumor screening is an important way to detect cancer and precancerous lesions early. Blood examination indicators in physical examination, B-ultrasound, X-ray, anorectal finger examination, Pap smear in gynecological examination, mammography, etc. are commonly used methods for screening tumors.

Diagnosis

Diagnosis and diagnosis of vulvar Ewing sarcoma

The diagnosis can be confirmed based on clinical manifestations and pathological examination.

Takeshima et al proposed that Ewing's sarcoma is easily misdiagnosed as adenocarcinoma in HE staining, and the rose-like structure can be clearly seen in the cell print. It is considered that the cell print can be combined if necessary, and other small round cells should be noted. Tumors such as malignant lymphoma, embryonal rhabdomyosarcoma and malignant melanoma, Merkel cell carcinoma, lipoma, and Pap sac cyst are identified.

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