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Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e31829863b3
Case Reports

Vaginal Epithelioid Angiosarcoma: A Potential Pitfall in Gynecologic Pathology

Richer, Maxime MD, PhD1; Barkati, Maroie MD, FRCPC2; Meunier, Caroline MD, FRCPC3; Fortin, Suzanne MD, FRCPC4; Provencher, Diane MD, FRCSC, FACOG5; Rahimi, Kurosh MD, MSc, FRCPC1

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Abstract

Objective: Epithelioid angiosarcoma of the vagina is a rare variant that can easily be misdiagnosed considering the much higher frequency of epithelial neoplasms at that particular site.

Material and Methods: We report the case of a 41-year-old gravida 2, para 1, aborta 1, with no prior history of irradiation, who consulted after the discovery of 3 lesions at the lower right portion of the vagina.

Result: The lesion consisted of epithelioid cells with high-grade nuclei and prominent nucleoli. These cells expressed CD31, CD34, factor VIII, Fli-1, vimentin, smooth muscle actin, and WT-1. Keratin 8/18 was focally positive. They were immunonegative for keratin AE1/AE3, keratin 34βE12, keratin 7, keratin 20, S100, HMB-45, myogenin, desmin, and human herpesvirus type 8. Polymerase chain reaction–based HPV viral search was also negative.

Conclusions: A broad immunohistochemical panel including antibodies against vascular differentiation markers as well as various cytokeratins allows proper diagnosis of this unusual and aggressive entity.

Copyright © 2014 by the American Society for Colposcopy and Cervical Pathology

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