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Myeloid Sarcoma of the Vagina: A Report of 2 Cases

Skeete, Desiree H.-A. DM(Path)1; Cesar-Rittenberg, Paula MD2; Jong, Roland MD3; Murray, Shawn K. MD4; Colgan, Terence J. MD5

Journal of Lower Genital Tract Disease: April 2010 - Volume 14 - Issue 2 - pp 136-141
doi: 10.1097/LGT.0b013e3181be2999
Case Reports

Objective: To describe 2 cases of myeloid sarcoma of the vagina, in a patient without a history of acute myeloid leukemia (AML) and in another whose condition was previously diagnosed with AML.

Materials and Methods: The clinical histories of 2 patients whose conditions were diagnosed with myeloid sarcoma of the vagina were obtained from their medical records.

Results: Case 1: A 77-year-old woman with no systemic illnesses presented with a vaginal lump. Clinically, there was a 6-cm periurethral mass that was examined by biopsy. The histopathologic specimen was evaluated on routine and immunohistochemical stains, and myeloid sarcoma was diagnosed after extensive immunohistochemical analysis. The patient was treated with pelvic radiation. She developed extensive myeloid sarcoma of the skin and AML 4.5 months later; she died 2 weeks later, 5 months after the initial presentation. Case 2: A 36-year-old woman with a known history of AML who has had multiple leukemic and extramedullary recurrences presented with a pelvic mass. Physical findings revealed large masses in the vagina and rectovaginal septum, which were confirmed as myeloid sarcoma after biopsy and histologic examination. The patient was treated with pelvic/vaginal radiation. Five months later, she had another leukemic relapse and died within 1 day of palliative chemotherapy.

Conclusions: Myeloid sarcoma of the vagina is extremely rare. Most patients have a poor prognosis and either have a history of or will subsequently develop AML.

A report of 2 cases of myeloid sarcoma of the vagina, one of which is an initial presentation.

1Department of Pathology, Faculty of Medical Sciences, Queen Elizabeth Hospital, St. Michael, Barbados; 2Division of Gynecologic Oncology, Dalhousie University/QEII Health Sciences Centre, Halifax, Nova Scotia, Canada; 3Laboratory Services, Lakeridge Health Corporation, Oshawa, Ontario, Canada; 4Department of Pathology, Dalhousie University/QEII Health Sciences Centre, Halifax, Nova Scotia, Canada; and 5Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada

Reprint requests to: Terence J. Colgan, MD, Pathology and Laboratory Medicine, Room 6-500-Mount Sinai Hospital, Joseph & Wolf Lebovic Health Complex, 600 University Ave, Toronto, Ontario, Canada, M5G 1X5. E-mail: tcolgan@mtsinai.on.ca

©2010The American Society for Colposcopy and Cervical Pathology