PMC5817301_01
Initial vaginal biopsy of the mass revealing poorly differentiated carcinoma with neuroendocrine features. The tumor cells show cytoplasmic staining with synaptophysin (black arrow), a marker protein for neuroendocrine cells. The staining surrounds the bluish nucleoli of tumor cells (T).
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fig1
Immunochemistry demonstrated dot-like staining focally for keratin 20 and diffused weak staining for synaptophysin (Figure 1) Positron emission tomography-computed tomography (PET/CT) done 5 weeks after initial visit showed only a hypermetabolic area localized to the vagina without evidence of regional or distant metastasis.
CT of the abdomen and pelvis shows a bulky and irregular pelvic mass measuring 7 x 5 x 6 cm (seen at the arrow in Figure 1).
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fig2
CT of the abdomen and pelvis showed a bulky and irregular pelvic mass measuring 7 x 5 x 6 cm (Figure 2) with right obstructive uropathy secondary to ureteral encasement by the pelvic mass.