PMC7757295_01
PMC7757295_02
A) T1 FAT SAT with contrast MRI shows mass occupying the vagina with heterogeneous enhancement; B) T2 without contrast showing the vaginal mass with cervical involvement and respect of posterior side of the bladder
PAMJ-37-169-g001.jpg
PMC7757295_02_PAMJ-37-169-g001.jpg
F1
Radiological studies (ultrasound and MRI) showed a heterogeneous mass measuring 5.1 x 6.2 x 6.5cm in cervico-vaginal region (Figure 1).
numerous intracellular and extracellular periodic acid-Schiff positive diastase, (periodic-acid-Schiff x400)
PAMJ-37-169-g002.jpg
PMC7757295_02_PAMJ-37-169-g002.jpg
F2
Microscopic examination showed neoplastic cells arranged in a reticular growth pattern with glomerular-like structures composed of a central blood vessel enveloped by atypical large pleomorphic cells with prominent nucleoli (Schiller-Duval bodies) and numerous intracellular and extracellular periodic acid-Schiff positive diastase (Figure 2).
immunohistochemistry stain shows focal positivity of AFP++ and cytokeratin (AE1/AE3)+
PAMJ-37-169-g003.jpg
PMC7757295_02_PAMJ-37-169-g003.jpg
F3
Immuno-histochemical studies revealed that the tumor cells were focally positive for alpha feto-protein (AFP) and cytokeratin (AE1/AE3) (Figure 3) and negative for skeletal muscle markers (desmin and myogenin), this result was confirmed by a second pathology look.
MRI 3 months after the surgery showed absence of centropelvic mass
PAMJ-37-169-g004.jpg
PMC7757295_02_PAMJ-37-169-g004.jpg
F4
The MRI monitoring after this neo-adjuvant chemotherapy showed a decrease in tumor volume by more than 50% but with cervical invasion a hysterectomy was indicated. There is no evidence of recurrence at two years of follow-up (Figure 4).