Primary Vulvar Ewing Sarcoma/Primitive Neuroectodermal Tumor: A Report of One Case and Review of the Literature Jie Yang, MD, Qi Guo, MD, Yunpeng Yang,

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Primary Vulvar Ewing Sarcoma/Primitive Neuroectodermal Tumor: A Report of One Case and Review of the Literature Jie Yang, MD, Qi Guo, MD, Yunpeng Yang, MD, Junji Zhang, MD, Jinghe Lang, MD, Honghui Shi, MD Journal of Pediatric and Adolescent Gynecology Volume 25, Issue 4, Pages e93-e97 (August 2012) DOI: 10.1016/j.jpag.2012.03.005 Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology Terms and Conditions

Fig. 1 A, the mass in left labium major and right inguinal lymphadenopathy. B, coronal view of the mass on T2 weighted MRI. C, lymphadenopathy of both inguinal on T2 weighted MRI. D, pulmonary nodules, and subpleural cords. E, multiple low density lesions in lumbar vertebra, sacrum, iliac bone. Journal of Pediatric and Adolescent Gynecology 2012 25, e93-e97DOI: (10.1016/j.jpag.2012.03.005) Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology Terms and Conditions

Fig. 2 Ewing's sarcoma in vulva. A, photomicrograph showing monomorphic population of small blue cells (hematoxylin and eosin). B, immunostaining for CD99 was positive with a membranous pattern. C, NSE immunostain with nuclear location. D, negative for AE1AE3 immunostain. (magnification ×150). Journal of Pediatric and Adolescent Gynecology 2012 25, e93-e97DOI: (10.1016/j.jpag.2012.03.005) Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology Terms and Conditions

Fig. 3 A, The Ewing sarcoma (EWS) gene on chromosome 22 combines with the ETS-like genes on either chromosome 11 (the FLI-1 gene) or chromosome 21 (the ERG gene). The recombined genes of t(11;22) and t(21;22) retain the DNA binding portion of the ETS-like oncogenes under the control of the EWS promotor. B, Reverse transcriptase-polymerase chain reaction analysis demonstrating EWS/ERG3 gene fusion. Each PCR reaction was performed with the patient’s RNA (panel 1) and control (panel 2). Journal of Pediatric and Adolescent Gynecology 2012 25, e93-e97DOI: (10.1016/j.jpag.2012.03.005) Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology Terms and Conditions