Vulvar angioendothelioma

　　1. Etiology

　　Vulvar angioendothelioma originates from Zimmermann's perivascular cells.

　　2. Pathogenesis

　　The tumor presents as a localized nodular mass with clear margins and a thin capsule, with an average diameter of 4-8 cm. The cut surface is grayish white to reddish brown, often accompanied by hemorrhage and cystic change, and necrosis can be seen in malignant cases. Microscopic examination shows a rich blood supply, lined with normal endothelial cells. The tumor cells are completely located outside the capillaries, and there is often a collagen fiber band between the blood vessels and tumor cells, with the tumor cells arranged in a whorl or radiating pattern around the blood vessels and collagen fiber bands. PAS or reticular fiber staining can clearly outline the vascular image. The histological differentiation between benign and malignant angioendothelioma cells is difficult. Malignancy is usually manifested by features such as tumor diameter exceeding 5 cm, cellular polymorphism, increased nuclear division, or regional necrosis. Tumors without these manifestations can also be considered potentially malignant because about 20% of them can have local infiltration or hematogenous metastasis. Immunohistochemistry shows strong positivity for vimentin. FXⅢa and HLA-DR can also be positive, but most of the tumor cells are stained only in 5% to 20%.

　　Vulvar angioendothelioma is characterized by the proliferation of tumor cells outside the basement membrane, which can be benign or malignant. Malignant cases can be called angioendothelioma or simply vulvar angioendothelioma. The histological differentiation between benign and malignant angioendothelioma cells is difficult, and it can be distinguished from other vulvar sarcomas by histopathology, electron microscopy, immunohistochemistry, and other examinations. Common complications of vulvar angioendothelioma include metastasis along blood vessels or lymph nodes.

　　The characteristics of external genital vascular epithelioma are that tumor cells proliferate outside the basement membrane. This disease often manifests as slowly growing irregular masses in the external genitalia, painless, superficial location of the mass, soft texture.

　　1. Tumor screening is an important way to early detect cancer and precancerous lesions. Various blood examination indicators in physical examinations, such as ultrasound, X-ray, anal and rectal examination, gynecological examination, such as Papanicolaou smear, breast molybdenum film, etc., are commonly used methods for tumor screening.

　　2. Regular physical examinations can improve survival rate and early prevention and treatment, and follow-up attention should be paid.

　　3. Prognosis is related to the size of the tumor. Metastasis usually occurs late, and Reymond et al. (1972) reported a case of external genital vascular epithelioma patient with femoral metastasis 14 years later.

　　The diagnosis of external genital vascular epithelioma depends not only on clinical manifestations, but also on related auxiliary examinations, which are indispensable. The main examination methods are as follows:

     1. Tumor marker examination, cytogenetic examination.

　　2. Histopathological examination, immunohistochemical detection.

　　One: Dietetic recipes for external genital vascular epithelioma

　　1. Heshouwu Egg Soup

　　Composition: 120 grams of heshouwu, 4 eggs.

　　Usage: Boil heshouwu to get a concentrated decoction, and boil 4 eggs. This is a daily dose, taken twice a day.

　　2. Black Sesame Brown Sugar Porridge

　　Composition: 200 grams of black sesame seeds, 30 grams of brown sugar.

　　Usage: Clean the black sesame seeds, slightly roast them, put them in a bottle for storage or crush and pack them in a bottle. Use 2 tablespoons with an appropriate amount of brown sugar, dip steamed bread or serve with boiling water.

　　3. Walnut and Sesame Seed Porridge

　　Composition: 200 grams of walnut kernel, 100 grams of sesame seeds, 100 grams of glutinous rice.

　　Usage: Grind the walnuts and sesame seeds into powder. Boil the glutinous rice with an appropriate amount of water, then add the walnuts and sesame seeds and it can be eaten.

　　4. Heshouwu Yam Mutton Soup

　　Composition: 30 grams of heshouwu, 100 grams of yam, 500 grams of lean mutton, 9 grams of ginger.

　　5. Meat 300 grams, fresh river fish 1 piece (500 grams), white radish 1 piece. Cut the mutton into large pieces, put it into boiling water, cook with sliced radish for 15 minutes, and discard the soup and radish. Put the mutton into the pot, add water (about 2/3 of the pot capacity), scallion, ginger, and wine, and cook until tender. If the soup is too little, add some boiling water. After the fish is fried with soybean oil, put it into the pot with mutton and cook for 30 minutes. Add salt, cilantro, green onion, and scallion to the soup, and it becomes a delicious and tasty mutton and fish soup. It is mainly used for postoperative nourishment.

　　Two: What is good for the body to eat for external genital vascular epithelioma

　　1. It is recommended to consume more foods with anti-external genital tumor effects, such as sesame seeds, almonds, wheat, barley, loofah, black-bone chicken, cuttlefish, green mamba, pork pancreas, chrysanthemum, black plum, peach, lychee, horse齿苋, chicken blood, eel, abalone, crab, tetrodotoxin, sardine, clam, and tortoise.

　　2. For pain, eat horseshoe crabs, red crabs, lobsters, sea snails, sea cucumber, tiger fish, beetroot, mung beans, radish, chicken blood.

　　3. For itching, eat amaranth, cabbage, rapeseed, taro, kelp, purple kelp, chicken blood, snake meat, pangolin.

　　4. To enhance physical fitness and prevent metastasis, eat silver ear, black fungus, shiitake mushrooms, hedgehog mushrooms, gizzard, sea cucumber, Job's tears, walnuts, crabs, Agama, needlefish, etc.

　　5. After surgery, consuming Qi and injuring blood, it is advisable to eat foods that nourish Qi and blood, such as jujube, longan, mung bean, glutinous rice, lychee, shiitake mushrooms, carrots, quail eggs, lotus root powder, beans, etc.

　　6. Radiotherapy after surgery: It consumes Yin and fluid, and it is advisable to eat foods that nourish Yin and fluid, such as spinach, small amaranth, lotus root, radish, watermelon, banana, grapes, sea cucumber, sugarcane, lily, etc.

　　7. Chemotherapy after surgery: It is easy to damage both the Qi and blood, and it is advisable to eat foods that nourish Qi and blood, such as mushrooms, shiitake mushrooms, walnuts, mulberries, Job's tears congee, red dates, longans, sea cucumber, etc.

　　Third, it is best not to eat the following foods for perineal vascular endothelial cell tumors

　　1. Abstain from food that causes heat. For example: fish, shrimp, crab, chicken head, pork head meat, goose meat, chicken wings, chicken feet, etc.

　　2. Eat less spicy and stimulating foods. For example: onions, pepper, chili, Sichuan pepper, rapeseed, fennel.

　　3. Avoid eating fried and greasy foods. For example: doughnuts, butter, butter, chocolate, etc., these foods have the effect of increasing dampness and heat, which will increase the secretion of leukorrhea and is not conducive to the treatment of the disease.

　　4. Quit smoking, drinking, coffee and other stimulating drinks.

　　The key to the treatment of perineal vascular endothelial cell tumor in Western medicine is early diagnosis and early treatment.

　　1. Surgical treatment:Wide excision of the external genitalia lesions before the occurrence of metastasis or radical excision of the external genitalia.

　　2. Chemotherapy:To improve the survival rate of patients, chemotherapy can be supplemented, which has a good therapeutic effect. Actinomycin D (regenerative mycin), cyclophosphamide and methotrexate in combination with chemotherapy have a good response.

　　3. Radiation therapy:Radiation therapy should be selected at an appropriate time after surgery, although the effect cannot be guaranteed, but a certain curative effect can also be obtained.