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Cervicovaginal Müllerian papilloma malignant transformation in a prepubertal girl
  1. Juan Zou1,2,
  2. Lingping Xie3,
  3. Xue Xiao1,4,
  4. Lian Xu1,2,
  5. Fan Yang1,2,
  6. Tong Qiu2,5,
  7. Kaixuan Yang1,2
  1. 1 Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China
  2. 2 Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
  3. 3 Department of Pathology, Cheng Du Shang Jin Nan Fu Hospital, West China Hospital, Sichuan University, Chengdu, China
  4. 4 Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
  5. 5 Laboratory of Stem Cell and Tissue Engineering, West China Second University Hospital, Sichuan University, Chengdu, China
  1. Correspondence to Professor Kaixuan Yang, Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu 610041, China; huaxipathkxy{at}163.com

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Clinical question

A 13-year-old girl presented with irregular vaginal bleeding for 2 years and aggravated 10 days. Anal examination showed a hard vaginal mass. On the MRI, a 7.1 cm×6.3 cm×5.5 cm mass at the upper part of the vagina was seen, the relationship with cervix was unclear. The biopsy revealed a malignant tumour with massive necrosis, tended to be rhabdomyosarcoma or the other sarcoma. Because the clinical stage was International Federation of Gynecology and Obstetrics IIA, neoadjuvant chemotherapy took before the radical operation.

Review the high-quality, interactive digital Aperio slides at http://virtualacp.com/JCPCases/jclinpath-2018-205612_1/ and http://virtualacp.com/JCPCases/jclinpath-2018-205612_2/ and consider your diagnosis.

What is your diagnosis?

  1. Mesonephric adenocarcinoma

  2. Serous carcinoma

  3. Malignant mixed Müllerian tumours

  4. Müllerian papilloma malignant transformation to endometrioid carcinoma

  5. Benign Müllerian papilloma

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The correct answer is after the discussion.

Discussion

Müllerian papilloma of the genital tract is rare. It mainly occurs in prepubertal girls ranging from 1 to 9 years old, and the major symptom is non-cyclical vaginal bleeding or discharge. Since James1 reported the first case in 1951, only 56 …

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