Vulvar sarcoma in a young patient with neurofibromatosis syndrome with missed opportunities: A case report

Authors

  • Dr. Consolata Wangeci Kihagi Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
  • Prof. Eunice Jeptoo Cheserem Department of Obstetrics and Gynecology Department, University of Nairobi, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
  • Dr. John Mwangi Kamau Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
  • Dr. Dorel Christian Ndayisaba Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
  • Dr. Alfred M. Mokomba Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
  • Dr. Rose Jepchumba Kosgei Department of Obstetrics and Gynecology, University of Nairobi; Kenyatta National Hospital, Nairobi, Kenya

DOI:

https://doi.org/10.59692/jogeca.v35i2.49

Keywords:

loss to follow-up, neurofibromatosis, vulvar sarcoma, vulvectomy

Abstract

Background: Vulvar malignancies are the fourth commonest of genital malignancies. The sarcoma type is associated with neurofibromatosis disease.

Case presentation: A 29-year-old nulliparous presented to the outpatient gynecological clinic with a five-year history of a recurrent right vulvar mass. The mass was initially excised without histological analysis. Histological examination of a reexcised mass diagnosed a spindle cell sarcoma. She was then lost to follow-up for one year. The mass recurred and she received external beam radiation. On admission, she was in good general status with generalized café-au-lait spots and neurofibromas. Perineal examination revealed an ulcerated right vulvar mass. Toilet vulvectomy and diversion colostomy were performed followed by chemotherapy. She was discharged after five months with a well-granulated wound. Colostomy was reversed six months later.

Conclusion: Vulvar sarcoma is a rare vulvar malignancy type usually associated with neurofibromatosis. This case highlights the missed opportunities in its management. A high suspicion threshold is critical for early diagnosis and management to curb the morbidity and mortality rate.

Author Biographies

Dr. Consolata Wangeci Kihagi, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya

Resident, Department of Obstetrics and Gynecology Department, University of Nairobi, Nairobi, Kenya

Prof. Eunice Jeptoo Cheserem, Department of Obstetrics and Gynecology Department, University of Nairobi, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya

Associate Professor and Chair, Department of Obstetrics and Gynecology Department, University of Nairobi, Nairobi, Kenya; Consultant, Department of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya

Dr. John Mwangi Kamau, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya

Resident, Obstetrics and Gynecology Department, University of Nairobi, Nairobi, Kenya

Dr. Dorel Christian Ndayisaba, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya

Resident, Obstetrics and Gynecology Department, University of Nairobi, Nairobi, Kenya

Dr. Alfred M. Mokomba, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya

Honorary Lecturer, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya; Consultant, Department of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya

Dr. Rose Jepchumba Kosgei, Department of Obstetrics and Gynecology, University of Nairobi; Kenyatta National Hospital, Nairobi, Kenya

Senior Lecturer, Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya; Consultant, Department of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya

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Published

2023-06-30

How to Cite

Kihagi, C. ., Cheserem, E., Kamau, J., Ndayisaba, D., Mokomba, A., & Kosgei, R. (2023). Vulvar sarcoma in a young patient with neurofibromatosis syndrome with missed opportunities: A case report. Journal of Obstetrics and Gynaecology of Eastern and Central Africa, 35(2), 63–66. https://doi.org/10.59692/jogeca.v35i2.49

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