case_images: PMC9396410_01
case_images: (A) A mass of approximately 1.0x1.5 cm was observed in the right labia majora. (B) A mass approximately 3.0x3.0 cm was observed in the anterior vaginal wall, and the inner wall of the vagina was smooth. (C) Photograph of the gross specimen: the mass in the anterior vaginal wall circumferentially encased the urethra.
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case_images: Physical examination revealed a mass of approximately 1.0x1.5 cm in the right labia majora ( Figure 1A ), a mass of approximately 3.0x3.0 cm in the anterior vaginal wall ( Figure 1B ), and enlarged right inguinal lymph nodes. The mass in the anterior vaginal wall circumferentially encased the urethra ( Figure 1C ) and was confirmed as adenosquamous carcinoma ( Figures 3A-C ) by histopathological examination.
case_images: MRI of the pelvis of the patient. (A) A mass in the right labia majora. (B, C) The right inguinal area showed swelling, multiple lymphadenopathies, and a mass in the anterior vaginal wall that surrounded the urethra and grew in a semi-encircled manner. (D) The mass in the anterior wall of the vagina was suspected to invade the urethra but only. Surrounded the urethra.
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case_images: Contrast-enhanced CT of the abdomen also revealed no abnormalities. Contrast-enhanced pelvic MRI showed a mass in the right labia majora ( Figure 2A ) and swelling of the right inguinal lymph nodes ( Figures 2B, C ). In addition, a mass was discovered in the anterior vaginal wall that surrounded the urethra and grew in a semi-encircled manner ( Figures 2B-D ).
case_images: The results of hematoxylin-eosin staining: (A) Both glandular and squamous components were present. (B) the glands in the adenocarcinoma area were cribriform, papillary arrangements and had patterns of invasive growth. (C) The area of squamous carcinoma displayed nest distribution, patchy necrosis, pathological nuclear division, and invasive growth. Immunohistochemically: the tumor cells were positive for (D) CK20, (E) CDX-2, and (F) Villin.
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case_images: The mass in the anterior vaginal wall circumferentially encased the urethra ( Figure 1C ) and was confirmed as adenosquamous carcinoma ( Figures 3A-C ) by histopathological examination. Immunohistochemically, the tumor cells were positive for CK20 ( Figure 3D ), CDX-2 ( Figure 3E ), villin ( Figure 3F ), CK5/6, CK7, and p40 and negative for both PSA and PSAP.
case_images: (A) MRI of the brain showed multiple lesions in the bilateral brain representing cerebral infarctions. Contrast-enhanced whole-body CT of the patient: (B) Filling defects in the segmental pulmonary artery of the right lower lobe were also seen, indicating the presence of thromboemboli. (C, D) There were multiple lesions in the abdominal cavity (involving the kidneys, liver, spleen, left adrenal gland, and left pelvic side and bilateral inguinal lymph nodes).
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case_images: MRI of the brain ( Figure 4A ) showed multiple cerebral infarctions, and contrast-enhanced whole-body CT ( Figures 4B-D ) revealed pulmonary embolism and multiple metastases in the abdominal cavity (involving the kidneys, liver, spleen, left adrenal gland, and left pelvic side and bilateral inguinal lymph nodes).