Primary adenocarcinoma of the vulva, possibly cloacogenic. A report of two cases.

Primary adenocarcinoma of the vulva, arising in continuity with the epidermis and unrelated to the underlying mucus glands, is a distinctly uncommon neoplasm. The origin of such an unusual tumor, although attributed to cloacal remnants, remains speculative. We describe two patients with this rare lesion. No other primary tumor was found in either of the two after a thorough investigation. One patient was treated with radical vulvectomy and was free of disease for 10 years, until her death from unrelated causes. The second patient was treated with wide local excision and was free of disease four years postoperatively. Our experience indicates the need to recognize this tumor as a primary and not metastatic neoplasm of the vulva. We also noticed that in both cases, despite its histologic malignancy and ulceration, the tumor was superficial in its extent and without any tendency for deeper invasion. It can therefore be treated effectively with wide local excision, thus eliminating the need for radical vulvectomy.

[Immunohistochemical localization of S-100 protein in granular cell myoblastoma]. / Localización inmunohistoquímica de la proteína S-100 en el mioblastoma de células granulares.

Three cases of granular cell myoblastoma have been studied in order to determine the presence and distribution of the S-100 specific protein in the neoplastic cells, using immunocytochemical staining techniques, through the modified avidin-biotin method. Positive immunostaining was observed in the three cases studied. The comparative study of various control cases histogenetically originating from neuroectoderm (melanoma) and specifically from Schwann cells, as also the presence of strongly positive staining in Schwann cells of peripheral nerve fibres situated inside and outside the tumor, support the concept of the neurogenic origin of this interesting tumor.

Aberrant breast tissue of the vulva. A case report and review of the literature.

Aberrant breast tissue may occur anywhere along the embryonic milk line. Only 17 instances of breast tissue of the vulva have been recorded in the English literature between 1900 and 1976. Review of these cases, as well as features of the patient herein reported, serve as a basis for presenting a clinical profile of this interesting entity, its potential complications, and a rationale for appropriate management.

Comparison of cancer cell surfaces of the lower reproductive tract by scanning electron microscopy.

The squamous cells of the cervix simulate those of the vagina and vulva both histologically and by scanning electron microscopy. However, in areas of the cervix undergoing active metaplasia, there are cells which share some of the characteristics demonstrated by scanning electron microscopy of both squamous and columnar epithelium. In these cells there is a wide range of characteristics of each cell type, suggesting a possible gradual transition from columnar to squamous epithelium. Furthermore, the cells of severe dysplasia and of intraepithelial and invasive squamous cancers of the cervix, though histologically similar to those of vaginal and vulvar cancers, are distinctly different when examined by scanning electron microscopy. These findings suggest that both metaplastic and neoplastic squamous cells are derived from the same progenitor columnar cells of the cervix, by orderly transition in the former and by atypical transformation in the latter. Second, the distinctiveness from the vaginal and vulvar cells indicates different embryonic stem cell lines.