Trichoblastic Carcinosarcoma Arising From the Vagina: A Case Report With Comprehensive Immunophenotypic Analysis

Int J Surg Pathol. 2020 Jun;28(4):440-446. doi: 10.1177/1066896919887803. Epub 2019 Nov 20.

Abstract

A 54-year-old woman presented with abdominal pain. Magnetic resonance imaging revealed an upper vaginal mass with no pelvic side wall involvement, nodal, or distant metastasis. Radical hysterectomy was performed. Histology showed trichoblastic carcinoma with hair follicle structures and malignant sarcomatous and carcinomatous components. Hair follicular differentiation was confirmed by positivity to hair follicle markers (Bcl-2, TLE1, CD56/NCAM, and TDAG51) and presence of CD10-positive trichogenic stroma. The tumor involved the vaginal muscularis only (FIGO [International Federation of Gynecology and Obstetrics] stage I) and was excised with clear margins. The patient remained disease free at 3-month follow-up. This is the first case of cutaneous-type carcinosarcoma reported in the vagina, highlighting the difference in histology, immunophenotype, and behavior compared with gynecologic carcinosarcomas.

Keywords: trichoblastic carcinosarcoma; vaginal carcinosarcoma.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / metabolism
  • Carcinosarcoma / diagnosis*
  • Carcinosarcoma / pathology
  • Carcinosarcoma / surgery
  • Diagnosis, Differential
  • Female
  • Hair Follicle / pathology*
  • Humans
  • Hysterectomy
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Middle Aged
  • Skin Neoplasms / diagnosis
  • Vagina / diagnostic imaging
  • Vagina / pathology*
  • Vagina / surgery
  • Vaginal Neoplasms / diagnosis*
  • Vaginal Neoplasms / pathology
  • Vaginal Neoplasms / surgery

Substances

  • Biomarkers, Tumor