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Myoepithelial tumors of the vulva are extremely rare, with only 8 cases reported in the literature to date. We report the first case of a high-grade myoepithelial vulvar carcinoma diagnosed in a 35-year-old woman during the 27th week of her pregnancy. The patient initially underwent a wide local excision of the lesion but noted rapid regrowth of the vulvar mass during the next 2 months before her delivery. Shortly thereafter, she underwent a classic radical Taussig-Basset total radical vulvectomy, bilateral superficial and deep inguinal groin node dissection, partial vaginectomy, and reconstruction of the vulva. However, the patient rapidly developed both locoregional and distant mestatatic disease, despite aggressive chemoradiotherapy, and she eventually succumbed to disseminated disease almost 20 months after her initial diagnosis.

Aims and Background The understanding of hormonal therapies in postmenopausal women with metastatic breast cancer has advanced greatly in the past several decades. With the introduction of orally active, potent and selective third-generation aromatase inhibitors (anastrozole, letrozole and exemestane), approaches to the treatment of hormone-sensitive advanced breast cancer are undergoing reevaluation. For treatment of advanced or metastatic disease that has progressed on tamoxifen, all three agents are active. The purpose of the study was to assess the antitumor efficacy and tolerance of exemestane administered as third-line hormonal therapy to postmenopausal women with metastatic breast cancer refractory to letrozole and anastrozole.Study design Sixty postmenopausal women with stage IV hormone receptor-positive carcinoma of the breast were enrolled in the study. All patients had received two prior hormonal manipulations and had measurable or assessable disease. All adverse events were monitored.Results Objective tumor response was achieved in 12 (20%) patients (95% CI, 9.6-30.4). The overall clinical benefit was 38.3% (95% CI, 21.2-49.3), and the median duration of objective tumor response was 20 months (range, 9-26). The median time to death was 17.4 months (95% CI, 16.14-18.66).Conclusions Exemestane represents an active and well-tolerated treatment option in pretreated patients with advanced breast cancer who have received standard first- and second-line hormonal therapies. By extending the sequence of hormonal therapy, disease progression and the need for chemotherapy may be significantly delayed.

Introduction. Leiomyoma is a benign vascular tumor affecting the greater saphenous vein rarely. Proper histopathological examination sets the diagnosis after complete and wide surgical excision along with a normal portion of the GSV. Case Presentation. A 36-year-old woman was admitted to our hospital complaining of a dull ache on her right groin for the last three months, along with a palpable mass on the mentioned area. An ultrasound (U/S) scan revealed a solid mass measuring 3×2 cm. After wide surgical excision, pathological examination revealed a leiomyoma of the GSV. Discussion. Benign and mostly malignant tumors arising from the GSV are reported in the literature before. Diagnostic modalities and clinical examination cannot set a correct diagnosis preoperatively due to no specific characteristics of these tumors. Possible sarcomatous behaviour has to be kept in mind when treating tumors arising from a vessel wall and wide surgical excision as negative margins should be attempted.