Uterine perivascular epithelioid cell tumor (PEComa) in a pediatric patient: case report

Authors

DOI:

https://doi.org/10.35509/01239015.888

Keywords:

Perivascular epithelioid cell neoplasms, uterine neoplasms

Abstract

PEComa is a perivascular epithelioid cell tumor of mesenchymal origin. These tumors correspond to a rare group of neoplasms. About 100 cases have been reported, of which only 30% are of gynecological origin, and the uterine body is the most frequent site. Due to its low frequency of appearance, there is no established medical conduct and treatment, which is why the management of this entity is a challenge. Presentation in the pediatric population is extremely rare, with limited data on its frequency in this age group. We present the case of a 13-year-old patient who consulted for pelvic pain. Diagnostic images were performed that documented a solid right para-adnexal mass. She was taken to surgery, which evidenced a tumor dependent on the uterine body with histology corresponding to a PEComa with characteristics of malignant behavior.

Author Biographies

Santiago Vieira-Serna, Fellow Unidad Funcional Ginecología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.

1. Fellow Unidad Funcional Ginecología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.

2. Posgrado de Ginecología Oncológica, Universidad Militar Nueva Granada, Bogotá, D.C., Colombia.

Claudia Rojas Salamanca, Servicio Ginecología Clínica de Marly Jorge Cavelier Gaviria, Bogotá, D.C., Colombia.

3. Servicio Ginecología Clínica de Marly Jorge Cavelier Gaviria, Bogotá, D.C., Colombia.

Diana Jimena Santana-Ballesteros, Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

4. Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

5. Unidad Funcional Ginecología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.

Oscar Fernando Serrano-Ortiz, Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

4. Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

Lina María Caicedo-Páez, Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

4. Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

David Andrés Viveros-Carreño, Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

4. Departamento de Ginecología Oncológica, Clínica Colsanitas, Bogotá, D.C., Colombia.

5. Unidad Funcional Ginecología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.

6. Departamento de Ginecología Oncológica, Clínica Los Nogales, Bogotá, D.C., Colombia.

References

Bennet J, Schoolmeester J. Perivascular ephitelioid cell tumour (PEComa). In: Female Genital Tumours, WHO Classification of Tumours. 5th Edition, Vol. 4. Lyon: International Agency for Research on Cancer; 2020. p. 296-7.

Apitz K. Die Geschwulste und Gewebsmissbildungen der Nierenrinde. II Midteilung. Die mesenchymalen Neubildungen. Virchows Arch. 1943;311:306-27.

Bonetti F, Pea M, Martignoni G, Zamboni G. PEC and sugar. Am J Surg Pathol. 1992;16(3):307. https://doi.org/10.1097/00000478-199203000-00013

Fadare O, Parkash V, Yilmaz Y, Mariappan MR, Ma L, Hileeto D, et al. Perivascular epithelioid cell tumor (PEComa) of the uterine cervix associated with intraabdominal "PEComatosis": a clinicopathological study with comparative genomic hybridization analysis. World J Surg Oncol. 2004;2:35. https://doi.org/10.1186/1477-7819-2-35

Papoutsis D, Sahu B, Kelly J, Antonakou A. Perivascular epithelioid cell tumour and mesonephric adenocarcinoma of the uterine cervix: an unknown co-existence. Oxf Med Case Reports. 2019:01:21-5. https://doi.org/10.1093/omcr/omy115

Folpe AL, Mentzel T, Lehr HA, Fisher C, Balzer BL, Weiss SW. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: A clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol. 2005;29(12):1558-75. https://doi.org/10.1097/01.pas.0000173232.22117.37

Kalyanasundaram K, Parameswaran A, Mani R. Perivascular epithelioid tumor of urinary bladder and vagina. Ann Diagn Pathol. 2005;9(5): 275-8. https://doi.org/10.1016/j.anndiagpath.2005.05.003

Gupta R, Hariprasad R, Dhanasekaran K, Gupta S. Malignant perivascular epithelioid tumor of the vagina: Report of a rare case with brief review of literature. Diagn Cytopathol. 2020;48(5):483-8. https://doi.org/10.1002/dc.24402

Fink D, Marsden DE, Edwards L, Camaris C, Hacker NF. Malignant perivascular epithelioid cell tumor (PEComa) arising in the broad ligament. Int J Gynecol Cancer. 2004;14(5):1036-9. https://doi.org/10.1111/j.1048-891x.2004.014549.x

Mathew M, Nayal B, Rao L, Nagel B. Broad ligament perivascular epithelioid cell tumor (PEComa) of uncertain malignant potential. Turk Patoloji Derg. 2016;32(1):44-6. https://doi.org/10.5146/tjpath.2014.01252

Schoolmeester JK, Howitt BE, Hirsch MS, Dal Cin P, Quade BJ, Nucci MR. Perivascular epithelioid cell neoplasm (PEComa) of the gynecologic tract: Clinicopathologic and immunohistochemical characterization of 16 cases. Am J Surg Pathol. 2014;38(2):176-88. https://doi.org/10.1097/PAS.0000000000000133

Ramaiah S, Ganesan R, Mangham DC, McNally O, Klys HS, Hirschowitz L. Malignant variant of sclerosing perivascular epithelioid cell tumor arising in the adnexa. Int J Gynecol Pathol. 2009;28(6):589-93. https://doi.org/10.1097/PGP.0b013e3181a3a4de

Tazelaar HD, Batts KP, Srigley JR. Primary extrapulmonary sugar tumor (PEST): A report of four cases. Mod Pathol. 2001;14(6): 615-22. https://doi.org/10.1038/modpathol.3880360

Conlon N, Soslow RA, Murali R. Perivascular epithelioid tumours (PEComas) of the gynaecological tract. J Clin Pathol. 2015;68:418-26. https://doi.org/10.1136/jclinpath-2015-202945

Vang R, Kempson RL. Perivascular epithelioid cell tumor ('PEComa') of the uterus: A subset of HMB-45-positive epithelioid mesenchymal neoplasms with an uncertain relationship to pure smooth muscle tumors. Am J Surg Pathol. 2002;26(1):1-13. https://doi.org/10.1097/00000478-200201000-00001

Bennett JA, Braga AC, Pinto A, et al. Uterine PEComas: A morphologic, immunohistochemical, and molecular analysis of 32 tumors. Am J Surg Pathol. 2018;42(10):1370-83. https://doi.org/10.1097/PAS.0000000000001119

Gadducci A, Zannoni GF. Perivascular epithelioid cell tumors (PEComa) of the female genital tract: A challenging question for gynaecologic oncologist and pathologist. Gynecol Oncol Reports. 2020;33:100603. https://doi.org/10.1016/j.gore.2020.100603

Musella A, De Felice F, Kyriacou AK, Barletta F, Di Matteo FM, Marchetti C, et al. Perivascular epithelioid cell neoplasm (PEComa) of the uterus: A systematic review. Int J Surg. 2015;19:1-5. https://doi.org/10.1016/j.ijsu.2015.05.002

Bennett JA, Oliva E. Perivascular epithelioid cell tumors (PEComa) of the gynecologic tract. Genes Chromosom Cancer. 2020;60(3):168-79. https://doi.org/10.1002/gcc.22908

Folpe AL, Goodman ZD, Ishak KG, Paulino A, Taboada EM, Meehan SH, et al. Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres: A novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults. Am J Surg Pathol. 2000;24(9):1239-46. https://doi.org/10.1097/00000478-200009000-00007

Cho H-J, Lee M-K, Kang B-M, Kim S-H, Chae H-D, Kim C-H. A 6-year-old girl with vaginal spotting who was diagnosed with perivascular epithelioid cell neoplasm after vaginoscopic resection. Obstet Gynecol Sci. 2014;57(5):409-11. https://doi.org/10.5468/ogs.2014.57.5.409

Ong LY, Hwang WS, Wong A, Chan MY, Chui CH. Perivascular epithelioid cell tumour of the vagina in an 8 year old girl. J Pediatr Surg. 2007;42(3):564-6. https://doi.org/10.1016/j.jpedsurg.2006.10.050

Agratal P, Anagani M, Agratal R. Uterine PEComa - A group of rare mesenchymal tumors. J Minim Invasive Gynecol. 2020;27(4): 803-4. https://doi.org/10.1016/j.jmig.2019.08.020

Jeon I-S, Lee SM. Multimodal treatment using surgery, radiotherapy, and chemotherapy in a patient with a perivascular epithelioid cell tumor of the uterus. J Pediatr Hematol Oncol. 2005;27(12):681-4. https://doi.org/10.1097/01.mph.0000193475.06870.d5

How to Cite

[1]
Vieira Serna, S. et al. 2023. Uterine perivascular epithelioid cell tumor (PEComa) in a pediatric patient: case report. Revista Colombiana de Cancerología. 27, 1 (Mar. 2023), 121–125. DOI:https://doi.org/10.35509/01239015.888.

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Published

2023-03-30

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Reportes de caso
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