title: Vaginal tubulovillous adenoma:  a clinicopathologic and molecular study with review of the literature.
abstract: Vaginal villous or tubulovillous adenomas (TVA) are uncommon tumors histologically similar to their intestinal counterparts. After reviewing the literature, we report the eighth case of TVA, which presented as a polypoid tumor in the vagina, at suburethral level, in a 19-yr-old woman with Arnold-Chiari type II malformation and a myelomeningocele at birth. The tumor consisted of long villi lined by columnar cells with brush borders, pseudostratified nuclei, and foci of high-grade atypia. Immunohistochemistry was positive for cytokeratin 7, estrogen and progesterone receptors, CA19.9, p16, p53, and Ki-67 (53%), with a normal membranous pattern for β-catenin, but negative for cytokeratin 20, CDX2, carcinoembryonic antigen, chromogranin A, and synaptophysin. Neither human papillomavirus nor mutations in the K-RAS, BRAF, or LKB1/STK11 genes were detected. Although a rare neoplasm, awareness of this tumor is important as it must be distinguished from colonic adenocarcinoma or other malignant or benign conditions. The existence of 2 previously reported malignant cases merging with TVAs, and the presence of foci of high-grade dysplasia (p53-positive) in the present case, support TVA as a premalignant lesion.
authors.affiliation: Department of Gynecology, University of Santiago de Compostela, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Peña-Fernández
authors.forename: Ihab
authors.initials: I
authors.lastname: Abdulkader-Nallib
authors.forename: Alejandro
authors.initials: A
authors.lastname: Novo-Domínguez
authors.forename: Elena M
authors.initials: EM
authors.lastname: Turrado-Sánchez
authors.forename: Alejandro
authors.initials: A
authors.lastname: Brea-Fernández
authors.forename: Laura
authors.initials: L
authors.lastname: Sebio-Lago
authors.forename: Clara
authors.initials: C
authors.lastname: Ruíz-Ponte
authors.forename: José
authors.initials: J
authors.lastname: Cameselle-Teijeiro
mesh_terms: D018253:Adenoma, Villous / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D001139:Arnold-Chiari Malformation / Q000150:complications; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008591:Meningomyelocele / Q000150:complications; D014625:Vaginal Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor