A case of alveolar soft part sarcoma with vaginal metastasis: Successful control of vaginal bleeding with external beam irradiation

Alveolar soft part sarcoma (ASPS) of the vagina is an exceptionally rare neoplasm. Furthermore, vaginal metastasis of ASPS has not been reported. A 28-year-old woman with a history of a right thigh mass diagnosed as ASPS excised 8 years ago presented to the emergency room with massive vaginal bleeding and anemia. Biopsy of a vaginal mass revealed that the tumor was a vaginal metastasis of ASPS. For control of intractable bleeding and preventing further transfusions, palliative radiation therapy was planned. She received a total of 39 Gy (daily 3 Gy, using 15-MV photons), and after 6-Gy irradiation, there was no more vaginal bleeding and no more transfusion needed. This is the first case of vaginal metastasis of ASPS reported in the literature that was manifested by intractable vaginal bleeding, which was controlled successfully with radiation therapy.