Soft-tissue Sarcoma of the Vagina and Vulva: a Clinicopathologic Study

Objective: To review the clinicopathologic characteristics of vulvovaginal soft-tissue sarcomas, and to correlate these variables with response to treatment.

Methods: We performed a retrospective review of the records of 24 women treated at Memorial Hospital for sarcoma of either the vulva or vagina over 20 years (1974-1993). Archival pathology specimens were reviewed to confirm the diagnosis, histology, and grade of the tumor.

Results: Fifteen patients had sarcomas arising from the vagina and nine had primary vulvar tumors. Leiomyosarcoma was the most common histology (n = 13). Twenty-three of 24 women underwent surgical excision as their primary therapy. Twenty-three were available for follow-up, and 16 of them (70%) are free of disease at a median follow-up time of 47 months (range 12-156, mean 59). Five women died of progressive disease and two are currently alive with persistent or recurrent disease. Grade was the most important predictor of outcome; all seven women with low-grade tumors are alive without evidence of disease.

Conclusion: Soft-tissue sarcomas are rare tumors of the lower genital tract. The primary therapy is surgical; adjuvant radiation therapy is indicated for high-grade tumors and locally recurrent low-grade sarcomas.