Epithelioid sarcoma of vulva: a case report and review of the literature.

Epithelioid sarcoma of vulva is an extremely rare and aggressive tumor. In most patients it is asymptomatic, and the lesions are usually mistaken for benign processes, leading to diagnosis at later stages. We report a case of vulvar epithelioid sarcoma in a 51-yr-old woman presenting with a nodularity of vulva. Left hemivulvectomy with bilateral inguinal lymph node dissection was performed. There was no evidence of distant metastasis at the time of diagnosis. Following adjuvant chemoradiotherapy and three cycles of chemotherapy, the patient developed lung metastasis 4 mo after surgery and died of disseminated disease after 6 mo of diagnosis. Vulvar epithelioid sarcoma is rare; showing different behavior changing from an extremely aggressive tumor to behaviors like low-grade tumors. It is best treated by early diagnosis and initial eradication. Definitive surgery provides excellent local control and survival in low-grade tumors. The role of adjuvant treatment remains to be determined.