PMC6336598_01
Operative image and specimen. (A) A significant vaginal tumor could be seen via the vagina cuff.
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F1
During the surgery, a significant vaginal tumor could be seen via the vagina cuff, and a very large vaginal tumor was excised (Fig. 1).
Hematoxylin-eosin staining. The neoplastic cells are arranged in solid nests or lobules with round to ovoid nuclei with clear to eosinophilic cytoplasm. Hypercellularity, marked nuclear pleomorphism, tumor necrosis, and carcinoma-like feature are noted. Frequent mitotic figures are found (13/10 high-power fields), x 200.
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F2
Hypercellularity, marked nuclear pleomorphism with high mitotic features (65/50 high-power field [HPF]), tumor necrosis, and carcinoma-like feature were noted (Fig. 2).
The neoplastic cells are immunoreactive for melan-A and focally positive for human melanoma black 45, actin, and transcription factor E3. The S-100, cytokeratin, and paired-box gene 8 immunostains are negative, x 4.
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F3
S-100, cytokeratin, and paired-box gene 8 immunostaining was performed and the results were negative (Fig. 3).
PMC6336598_02
PMC6336598_03