Soft tissue sarcomas of vulva

Our plain-English summary of Soft tissue sarcomas of vulva, by I. Davos, M.R. Abell (Gynecologic Oncology, 1976).

The study

• Authors: I. Davos, M.R. Abell
• Journal: Gynecologic Oncology
• Published: 1976;4(1):70-86
• Cited by: 55 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Fifteen cases of vulvar sarcomas were studied. The most common neoplasm was leiomyosarcoma, which also had the least favorable prognosis with a tendency to develop local recurrences and disseminated hematogenous metastases. The second most frequent sarcoma belonged to the fibrous histiocytoma group. Although they are unpredictable, they tended to be less aggressive than the leiomyosarcomas. Other sarcomas encountered were fibrosarcoma, hemangiosarcoma, malignant hemangiopericytoma, epithelioid sarcoma, neurogenous sarcoma, malignant mesothelioma, and embryonal stromal sarcoma. Local recurrences were common in the series due in part to inadequate initial treatment. It was evident from the study that wide local excision or radical vulvectomy early in the disease with bilateral lymph node resection for those sarcomas that have a potential for lymphogenous metastases is the treatment of choice and gives the most favorable results. In the presence of local recurrences, aggressive surgical treatment is indicated and increases the survival rate significantly.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This case series reviewed all vulvar soft tissue sarcomas in University of Michigan pathology files from 1935 to 1974. Fifteen patients, aged 16 to 84 (average 46), met their criteria; leiomyosarcoma, in five (33%), was the most common type. One tumor, in a 38-year-old patient, was interpreted as a malignant mesothelioma: a 3.5 cm encapsulated labium majus tumor beside the round ligament. Special stains were supportive but not diagnostic of mesothelial origin; the authors placed its origin in the process vaginalis peritonei. It did not recur after wide local excision or vulvectomy. Of 14 patients followed, 11 were alive and clinically disease-free 5 months to 20 years after diagnosis; three died with metastases. The article does not mention asbestos. The authors concluded that wide local excision or radical vulvectomy with bilateral inguinal node resection was indicated in most instances and gave the best results. They noted treatment could vary with tumor type and size, and specified node resection for sarcomas able to spread through lymphatics. They said the small number of cases did not allow valid prognostic conclusions.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series: retrospective review of pathology archive material with clinical follow-up
• Who was studied: 15 patients with soft tissue sarcoma of the vulva, aged 16 to 84 years (average 46), University of Michigan Medical Center, 1935 to 1974
• Main results:
  • Leiomyosarcoma was the most common type, in 5 of the 15 patients (33%)
  • Nine of the sarcomas occurred during a period when 492 primary malignant vulvar neoplasms were registered, an occurrence rate of 1.8%
  • One patient, aged 38, had a tumor listed as malignant mesothelioma
  • The tumor interpreted as a mesothelioma was a 3.5 cm encapsulated tumor in the labium majus, next to the round ligament
  • Special stains were supportive but not diagnostic of mesothelial origin; the authors considered the tumor to originate from the process vaginalis peritonei
  • The authors considered the mesothelioma malignant because of nuclear pleomorphism and frequent mitotic figures
  • The malignant mesothelioma, three malignant fibrous histiocytomas and one leiomyosarcoma did not recur after wide local excision or vulvectomy
  • Of 14 patients with survival information, 11 were alive and clinically free of disease 5 months to 20 years after diagnosis
  • Three patients died with local recurrences and metastases
  • In their opening summary, the authors specified bilateral lymph node resection for sarcomas with a potential for lymphogenous metastases
• The authors' conclusion: The authors concluded that, although treatment may be modified somewhat by histologic type and size of the lesion, wide local excision or radical vulvectomy with bilateral inguinal lymph node resection is indicated in most instances and gives the best results
• Limitations the authors state:
  • The small number of cases, the variety of tumor types and the short follow-up for some patients did not allow valid prognostic conclusions

Topics

Medical terms in this study, explained in our Lexicon: Sarcoma, Neoplasm, Prognosis, Epithelioid, Malignant Mesothelioma, Bilateral.

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• Vulvar sarcomas: Short guideline for histopathological recognition and clinical management. Part 2 — A.A. Chokoeva, G. Tchernev, et al. (2015)
• Expression of E-cadherin in bone and soft tissue sarcomas: a possible role in epithelial differentiation — H. Sato, T. Hasegawa, et al. (1999)
• Two cases of secondary soft tissue sarcomas after radiotherapy and radiochemotherapy — C. Saggia, G. Forti, et al. (2004)
• Epithelioid sarcoma. A clinical and pathologic study of nine cases — H. Santiago, L.K. Feinerman, et al. (1972)
• The diversity of soft tissue tumours with EWSR1 gene rearrangements: a review — C. Fisher (2014)
• Application of markers in the diagnosis of soft tissue tumours — P.J. Roholl, A.S. De Jong, et al. (1985)

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