The youngest documented patient of a rare case of uterine spindle cell sarcoma

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Katherine Artis

Ipswich Hospital, Australia

: Androl Gynecol: Curr Res

Abstract

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A recent report in the American Journal of Surgical Pathology described for the first time the presence of NTRK gene rearrangements in four undifferentiated uterine sarcomas with fibrosarcoma-like morphology. We encountered a patient with whom the pathology showed a uterine spindle cell sarcoma with NTKR fusion. She was the youngest known patient with this rare form of uterine sarcoma. The patient is 16-old-years lady who was referred to the gynecological oncology department for ongoing management of a cervical lesion in which the biopsy returned showing an atypical spindle cell tumor. On immunehistochemical stain it appeared to be a schwannoma of the cervix or a melanoma. The patient initially presented to her local gynecologist with a four-month history of a clear vaginal discharge and a vaginal examination demonstrating a cervical polyp. An MRI pelvis was performed and showed a polypoid mass within the vaginal vault, appearing to be arising from the left side of the cervix measuring approximately 41x25x51 mm. An examination under anesthetic, resection of the cervical mass, hysteroscopy and endocervical curettage was performed. The histopathology was reviewed and a second opinion was sought from the Brigham and Women’s Hospital, USA. The specimen showed an exophytic lesion composed of cells having atypical ovoid or tapering nuclei. Immunostains showed focal positivity for SMA along with multifocal positivity for S100 protein and CD34, in addition to which there was diffuse positivity for PAN-TRK. The appearance of the neoplasm combined with its immunopheno typed fitted well with the recently described uterine spindle cell sarcoma with NTKR fusion. There are currently only four cases (three of which are cervical origin) reported within the literature. Twelve months following her surgery the patient has recovered well. Additionally, on examination and imaging there are no signs of any recurrence or metastasis related to the uterine spindle cell sarcoma. This interesting case may assist other gynecologists who are presented with histopathological findings of an unusual uterine spindle cell sarcoma.

Biography

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Katherine Artis is currently an Obstetrics and Gynecology Unaccredited Registrar working in Sunny, South-east Queensland. She has a passion for Women’s Health and aspires to become an Obstetrician and Gynecologist.

E-mail: katherine.artis@health.qld.gov.au