Primary malignant nerve sheath tumor of the uterine cervix: A case report and literature review.

Abstract

Objective: Primary malignant nerve sheath tumor (MNST) of the uterine cervix is an extremely rare neoplasm. We report another case of this uncommon tumor and review all previously documented cases. Method: The repeated curettements in a 57-year-old woman with a history of prolonged vaginal bleeding revealed polypoid fragments of a sarcomatous neoplasm. In August 1997, total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Postoperatively, the patient received six courses of chemotherapy. Twenty-three months later, a local vaginal and left parametrial recurrence appeared and persisted for months despite the external radiotherapy and chemotherapy implemented. Fifty-seven months following the surgery, the patient died from lung metastases. Results: The cervix was enlarged, markedly distorted by 5.5×2.5×2.5-cm neoplasm involving predominantly the upper lip. Microscopically, the tumor had a variable sarcomatous appearance, suggestive of a MNST. Immunohistochemical examination demonstrated that many of the tumor cells reacted only with S-100 and vimentin. Conclusion: Only nine cases of MNST at this location have been reported presenting as polypoid masses measuring from 1.2 to 6 cm, occurring in patients ranging in age from 22 to 73 years. This additional case suggests that primary MNST of the uterine cervix appear to have clinical and pathological features similar to MNST at other locations.