Wang JX, Zhang H, Ning G, Bao L. Vulvovaginal myeloid sarcoma with massive pelvic floor infiltration: A case report and review of literature. World J Clin Cases 2022; 10(23): 8312-8322 [PMID: 36159511 DOI: 10.12998/wjcc.v10.i23.8312]
Corresponding Author of This Article
Heng Zhang, MD, PhD, Attending Doctor, Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education; West China Second University Hospital, Sichuan University, No. 20 South Renmin Road, Wuhou District, Chengdu 610041, Sichuan Province, China. mazy6121981@163.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2022; 10(23): 8312-8322 Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8312
Vulvovaginal myeloid sarcoma with massive pelvic floor infiltration: A case report and review of literature
Jia-Xi Wang, Heng Zhang, Gang Ning, Li Bao
Jia-Xi Wang, Heng Zhang, Gang Ning, Li Bao, Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education; West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jia-Xi Wang, Department of Radiology, Renshou Maternity and Child Health Hospital, Meishan 620500, Sichuan Province, China
Author contributions: Zhang H made a contribution to study conception and design; Wang JX and Zhang H collected data during the study; Wang JX was responsible for manuscript drafting, which was then reviewed and intensively revised by Zhang H; Bao L contributed to MRI scans and reconstructed the MRI image; Ning G critically reviewed and supervised the study; all authors contributed to the manuscript preparation, read and approved the final text.
Informed consent statement: The written consent was obtained from the patient for publication of this report and any accompanying images, ensuring de-identified personal or clinical details.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Heng Zhang, MD, PhD, Attending Doctor, Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education; West China Second University Hospital, Sichuan University, No. 20 South Renmin Road, Wuhou District, Chengdu 610041, Sichuan Province, China. mazy6121981@163.com
Received: February 21, 2022 Peer-review started: February 21, 2022 First decision: May 30, 2022 Revised: June 13, 2022 Accepted: July 8, 2022 Article in press: July 8, 2022 Published online: August 16, 2022
Abstract
BACKGROUND
Myeloid sarcoma (MS), including isolated and leukaemic MS, is an extramedullary myeloid tumour. MS can involve any anatomical site, but MS of the female genital tract is rare, with the ovaries and uterine body and cervix being the most commonly seen sites. Involvement of the vagina and vulva is extremely rare.
CASE SUMMARY
We report a rare case of MS with involvement of the vulva and vagina and massive infiltration of the pelvic floor. A 26-year-old woman presented with a vulvar mass, irregular vaginal bleeding and night sweats. Magnetic resonance imaging demonstrated an ill-defined, irregular vulvovaginal mass with massive involvement of the paravaginal tissue, urethra, posterior wall of the bladder, and pelvic floor. The signal and enhancement of the huge mass was homogeneous without haemorrhage or necrosis. Positron emission tomography/computed tomography showed high fluorodeoxyglucose uptake by the mass. Peripheral blood count detected blast cells. Vulvovaginal mass and bone marrow biopsies were performed, and immunohistochemistry confirmed the diagnosis of acute myeloid leukaemia (M-2 type, FAB classification) and vulvovaginal MS. The patient was treated with induction chemotherapy followed by allogeneic haematopoietic stem cell transplantation, and achieved complete remission. A systemic review of the literature on vulvovaginal MS was conducted to explore this rare entity’s clinical and radiological features.
CONCLUSION
Vulvovaginal MS is extremely rare. Diagnosis of vulvovaginal MS can only be confirmed histopathologically. Even though its clinical and imaging presentations are nonspecific, MS should be considered in the differential diagnosis of a newly developed T2-hyperintense, homogeneously enhanced vulvovaginal mass, especially in a patient with suspected haematological malignancy.
Core Tip: Female genital tract involvement in myeloid sarcoma (MS) is rare, and involvement of the vagina and vulva is extremely rare. Vulvovaginal MS can be localised or invade the adjacent cervix or paravaginal tissue. We report a rare case of MS with involvement of the vulva and vagina as well as massive infiltration of the pelvic floor. The clinical, pathological and imaging characteristics and treatment are reviewed to probe this rare entity.
