Vulvar liposarcoma
Introduction
Introduction to vulvar liposarcoma Lipoma is common in the trunk, limbs and abdomen, and liposarcoma that occurs in the vulva is rare. Mainly manifested as a painless mass that grows slowly under the skin, it has a polypoid appearance and can be accompanied by a sense of fluctuation. Occasionally manifested as vulvar pain, discomfort, progressive weight loss, mostly occurred in the labia majora, less clitoris and other parts. In the reported cases, all cases were misdiagnosed as benign lipoma or Pap sac cyst. basic knowledge The proportion of illness: 0.005% Susceptible people: women Mode of infection: non-infectious Complications: lung metastases
Cause
The cause of vulvar liposarcoma
(1) Causes of the disease
The cause of vulvar liposarcoma may be related to genetic mutations.
(two) pathogenesis
The mass is often large, generally 5 to 10 cm in diameter, and up to 15 cm. It is nodular or lobulated. The surface often has a pseudo-envelope. The cut surface is fat yellow, mucoid or fish-like, often with bleeding and necrosis. .
Microscopic examination showed that the different levels of lipoblasts were different in size, star shape, fusiform shape, round shape, "printed ring shape", etc. The lipid droplets had clear boundary, round and smooth, completely transparent, and the vacuoles were large and often Squeeze the nucleus to the margin or scalloped. In the pleomorphic liposarcoma, a large deformity multi-cavitating lipoblastic cell is common. In the mucin-like liposarcoma, except for the lipoblastic cell and the mucin-like matrix, a fine plexus capillary network can be seen. There may be light blue mucus and fat droplets between the tumor cells.
Fat staining (Oil Red O, Sudan, Scarlet, etc.) is often positive, and immunohistochemical staining of S-100 is irregularly positive.
Mucin-like liposarcoma, characteristic chromosomal translocation t(12;16)(q13;p11) can be detected in some well-differentiated and pleomorphic liposarcoma, or can be detected by RT-PCR and DNA dot blot. FUS/TLS-CHOP chimeric transcription due to chromosomal translocation.
Prevention
Vulvar liposarcoma prevention
Do a good job in prevention and treatment according to the third-level prevention of tumors.
Complication
Vulvar liposarcoma complications Complications
There will eventually be a lung metastasis.
Symptom
Vulvar liposarcoma symptoms Common symptoms Vulvar pain congestion of the labia majora or anus large... Progressive wasting
Symptom
At the beginning, the mass is small, located under the skin, without any symptoms. Afterwards, the mass gradually enlarges and invades the skin to form ulcers. When the infection is combined, pain and bleeding may occur. Patients often see a diagnosis due to a lump, bleeding and pain. In some cases, the tumor may be swollen. No change in a few years, then it increased rapidly.
2. Signs
The genital mass is often located in the labia majora. It is rare in other parts. The size of the tumor is 1~5cm. It is round or oval, isolated or multiple. The surface of the tumor in the early stage is intact. As the tumor develops, the skin becomes congested and ulcerated after infection. And bleeding, advanced tumors may invade deep tissues, but fixed on shame, ischial bone, or distant metastasis.
Examine
Examination of vulvar liposarcoma
Needle aspiration biopsy, tumor marker examination.
Histopathological examination.
Diagnosis
Diagnosis and differentiation of vulvar liposarcoma
diagnosis
According to clinical manifestations, physical signs and pathological examinations are clearly diagnosed. For patients with infiltrated skin or skin ulcers, biopsy can be taken. If the skin is intact, it can be used for needle biopsy or needle biopsy. It can also be used for biopsy or biopsy.
Differential diagnosis
1. Well-differentiated liposarcoma needs to be differentiated from lipoma and pituitary cysts. Lipomas have no cell size and nuclear atypia. The fiber spacing is narrow and not obvious, and no atypical cells and lipoblasts infiltrate.
2. Mucin-like liposarcoma needs to be associated with other embryonic or mucinous degenerative soft tissue sarcomas such as mucinous malignant fibrous histiocytoma, grape cluster rhabdomyosarcoma, mucinous degeneration of cutaneous fibrosarcoma, invasive angiomyxoma, mucus Sexual leiomyosarcoma is differentiated. The main difference is that the latter has no typical plexiform capillary network. The blood vessels of mucinous malignant fibrous histiocytoma are often arched, with many abnormal tumor cells and rich background collagen. In the pleomorphic area, grape cluster rhabdomyosarcoma has a layer in the subepithelial area of the mucosa. Straight line myoblasts can be seen instead of lipoblasts. The mucocutaneous degeneration of hyperficial cutaneous fibrosarcoma can be very similar, but its position is superficial. , close to the skin.
