Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2016; 4(4): 118-123
Published online Apr 16, 2016. doi: 10.12998/wjcc.v4.i4.118
Primary extragastrointestinal stromal tumor arising in the vaginal wall: Significant clinicopathological characteristics of a rare aggressive soft tissue neoplasm
Qiu-Yu Liu, Yun-Zhen Kan, Meng-Yang Zhang, Ting-Yi Sun, Ling-Fei Kong
Qiu-Yu Liu, Yun-Zhen Kan, Meng-Yang Zhang, Ting-Yi Sun, Ling-Fei Kong, Department of Pathology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China
Author contributions: Liu QY participated in collecting case information about the patient and drafted the manuscript; Kan YZ, Zhang MY and Sun TY performed the literature review and provided the experimental technical assistance; Kong LF assisted in revising the manuscript; all the authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Henan Provincial People’s Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors state that they have no conflict of interest.
Open-Access: 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/
Correspondence to: Ling-Fei Kong, PhD, Professor of Pathology, Chief, Department of Pathology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, 7 Weiwu Road, Zhengzhou 450003, Henan Province, China. lfkong9@163.com
Telephone: +86-371-65580256 Fax: +86-371-65580256
Received: November 5, 2015
Peer-review started: November 6, 2015
First decision: December 23, 2015
Revised: December 30, 2015
Accepted: February 14, 2016
Article in press: February 16, 2016
Published online: April 16, 2016
Abstract

Gastrointestinal (GI) stromal tumor is the most common mesenchymal neoplasm of the GI tract but also occurs with a lower frequency in extragastrointestinal regions and is called extragastrointestinal stromal tumor (EGIST). We report an unusual case of EGIST presenting as a vaginal mass. A 41-year-old woman presented with a gradually enlarging vaginal mass for the last 2 years. Physical examination revealed an elliptical, non-tender mass about 7.5 cm × 7 cm in size in the posterior vaginal wall and was resected completely. Under histological examination, the tumor showed a spindle cell type with coagulation necrosis, hemorrhage and high mitotic count. Immunohistochemical analysis revealed tumor cells were positive for DOG1, CD117, CD34 and p53 protein. Ki-67 labeling was 8%. Genetic analysis showed a deletion of exon 11 of the c-kit gene at codons 557-558. EGISTs should be kept in mind in the differential diagnosis in patients presenting with solid mass of the vaginal wall.

Keywords: Platelet derived growth factor receptor alpha, Extragastrointestinal stromal tumors, Vagina, c-kit, Mutation

Core tip: Gastrointestinal (GI) stromal tumor is the most common mesenchymal neoplasm of the GI tract but also occurs with a lower frequency in extragastrointestinal regions and is called extragastrointestinal stromal tumor (EGIST). We report an unusual case of EGIST presenting as a vaginal mass and describe its clinicopathological, immunohistochemical and genetic features. Our data shows that this case was a primary malignant EGIST in the vaginal wall but few cases of primary vaginal EGIST have been reported to date. EGISTs should be kept in mind in the differential diagnosis of patients presenting with a solid mass of the vaginal wall.