Investigations
The initial pathologic consideration of a recurrent tumor was a malignant nerve sheath tumor of the vulva. Due to this tumor’s rarity in the vulva, the case was presented at the International Gynecologic Cancer Society monthly videoconference with collaboration from multiple international sub-specialists and pathologists. It was established that the primary and recurrent tumors exhibited similar morphology and presented as a high-cellular spindle cell neoplasm (Figure 1 a,b,c,d). Immunohistochemistry showed tumor cells stained positive for SMA, calponin, and CD10. Negative for desmin, h-caldesmon, CD117, CD34, HMB-45, BCL-2, cytokeratin, EMA, and p63. CD68 highlighted multinucleated macrophages.