title: Endodermal sinus tumor of vagina posing a diagnostic challenge and managed by chemotherapy and novel posterior sagittal surgical approach: lessons learned.
abstract: Vaginal germ cell tumor (GCT) is a rare gynecological malignancy with no more than 100 reported cases in the international medical literature. It is an unusual, but an important, cause of premenarchal vaginal bleeding in a child. This article describes a 2-year-old child with vaginal GCT, initially misdiagnosed as rhabdomyosarcoma (on imprint smear cytology) and then as clear cell adenocarcinoma. The authors highlight the salient differentiating clinical, radiological and histological features to prevent misdiagnosis in future. The report emphasizes the need for increased awareness and screening for vaginal GCT by estimation of serum α-fetoprotein levels, in all patients with premenarchal vaginal bleeds, to prevent inadvertent operative interventions.
authors.affiliation: Department of Pathology, University College of Medical Sciences, New Delhi, India.
authors.forename: Surbhi
authors.initials: S
authors.lastname: Goyal
authors.forename: Archana
authors.initials: A
authors.lastname: Puri
authors.forename: Kiran
authors.initials: K
authors.lastname: Mishra
authors.forename: Satish Kumar
authors.initials: SK
authors.lastname: Aggarwal
authors.forename: Manisha
authors.initials: M
authors.lastname: Kumar
authors.forename: Pitamber
authors.initials: P
authors.lastname: Sonaker
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D003951:Diagnostic Errors; D004317:Doxorubicin / Q000008:administration & dosage; D018240:Endodermal Sinus Tumor / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D014592:Uterine Hemorrhage / Q000209:etiology*; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide
keywords: endodermal sinus tumor; germ cell tumor; posterior sagittal approach; premenarchal vaginal bleed; α-fetoprotein