Vulvar Myxoid Liposarcoma

■Lipomas are adipose tumors that are often located in the subcutaneous tissues of the head, neck, shoulders, and back.Lipomas have been identified in all age groups but most often appear between the ages of 40 and 60 years.These tumors are slow-growing and often benign and usually present as non-painful, round, mobile masses with a characteristic soft, doughy feel.Although rare, myxoid liposarcoma should be considered in the differential diagnosis of a vulvar soft tissue mass.A 45-year-old, gravida 3, para 3, abortus 0, patient visited our outpatient department because of a palpable vulvar tumor.The tumor became painlessly enlarged during the 2 months after the first visit.On examination, a fluctuant polypoid mass measuring 7 cm in diameter that involved the right labium majus was noted.Lipoma was suggested.No inguinal lymphadenopathy was noted.Genital examination and Papanicolaou smear results were normal.There were no special findings on the biochemical examination.A simple operation was arranged to excise the tumor mass.Operative and postoperative courses were smooth.The pathologic report showed "myxoid liposarcoma" (Figures 1 and2), and so the final diagnosis was vulvar liposarcoma stage Ib based on the characteristics: (1) tumor size of 7 × 5 cm; (2) no palpable lymph node; and (3) smooth-surfaced tumor mass.The patient was well until 16 months later after the surgery.The tumor mass recurred over the right labium majus and inguinal region (6 × 5 cm in size; Figure 3).An extensive excision was chosen by the patient's family for cosmetic reasons.A repeat excision of subcutaneous fat tissue was performed down to the superficial fascia of the urogenital diaphragm with a 3-cm margin of normal skin (Figure 4).Twenty-eight months after the surgery, the patient was still well without recurrence of the disease.Myxoid liposarcoma may present in a variety of different types, both clinically and histologically [1,2].As myxoid liposarcomas are rare, both pathologists and clinicians should be aware of the occurrence of this entity in the vulva to ensure the correct diagnosis and appropriate management of the patient with this potentially curable neoplasm [3].