Granular myoblastoma of the vulva

　　1. Etiology

　　Electron microscopy has confirmed that the tumor cells originate from the deformation of Schwann cells. There have been various theories about its tissue origin. Previously, it was believed to be formed by the degeneration of mature striated muscle, then considered to come from immature striated muscle, and later, some scholars believed it to come from tissue cells or fibroblasts.

　　2. Pathogenesis

　　The tumor is often located in the labia majora, grows slowly, and locally presents as nodular swellings. It is usually solitary, with a diameter of 0.5-3cm, generally with a wide base, and rather tough texture. The cut surface has no capsule. The boundary is clear, the texture is uniform, and the cut surface is pale yellow or grayish yellow with luster.

　　Microscopic examination shows that the tumor cells are arranged in coarse strands or nests, separated by fine fibers. The cells are large, polygonal, with unclear boundaries, rich cytoplasm, and contain obvious fine erythrosin granules. The nucleus is large or small, located in the center, and the nucleolus is clear. The cytoplasmic granules are not mucin, nor glycogen, but Sudan black B is positive, and PAS staining remains positive after enzymatic digestion, indicating that it is very likely to be glycoprotein with lipid substances, which supports the theory of its neurogenic tissue origin.

　　Vulvar granular myoblastoma usually has no specific symptoms, grows slowly, and has no obvious tenderness, so it is often overlooked. It is mostly discovered by patients by chance.

　　It often occurs with concurrent granular myoblastoma in the respiratory tract. Since tumor cells can invade the upper respiratory tract and the gastrointestinal tract, it can lead to the simultaneous occurrence of granular myoblastoma in the respiratory tract. There are usually no obvious symptoms, but when the tumor grows larger, it may manifest as a foreign body sensation in the upper respiratory tract, with symptoms such as frequent sneezing and nasal congestion.

　　1. There are usually no specific symptoms, and sometimes patients偶然 discover a growth in the vulvar area by chance. The growth in the vulvar tumor is often slow-growing, painless, and located deep in the tissue of the labia majora.

　　2. During gynecological examination, a vulvar mass with medium texture is often found, usually solitary, sometimes multiple, and without tenderness.

　　3. The mass is rather tough, with a diameter less than 1cm, and occasionally multiple nodules. The surface skin may sometimes have pigment reduction, and it can invade the vulva and other parts of the body.

　　1. Prevention:To prevent malignancy, extensive surgical resection should be performed, and follow-up work should be done well after surgery.

　　2. Diagnosis:There are usually no specific symptoms, and sometimes patients偶然 discover a growth in the vulvar area by chance. The growth in the vulvar tumor is often slow-growing, painless, and located deep in the tissue of the labia majora. During gynecological examination, a vulvar mass with medium texture is often found, usually solitary, sometimes multiple, and without tenderness. The mass is rather tough, with a diameter less than 1cm, and occasionally multiple nodules. The surface skin may sometimes have pigment reduction, and it can invade the vulva and other parts of the body. Diagnosis can be confirmed based on the history of the disease and tissue biopsy. Solitary tumors are generally benign, while multiple ones should be cautious of malignancy.

　　3, Concurrent diseases:Simultaneous occurrence of granular rhabdomyosarcoma in the respiratory tract.

　　First, vaginal secretion examination

　　Observe the color and nature of vaginal discharge. Vaginal discharge is the liquid secreted by the female reproductive system, also known as leukorrhea. The examination may occasionally find an increase in white blood cell count.

　　Second, tumor marker examination

　　Tumor markers (Tumor Marker) are chemical substances that reflect the presence of tumors.

　　1, Tumor tissues produced, including: differentiation antigens; embryonic antigens (AFP, CEA); isoenzymes (NSE); hormones (HCG); tissue-specific antigens (PSA, freePSA): mucins, glycoproteins, glycolipids (CA125); oncogenes and their products; polyamines, etc.

　　2, Tumors produced after interaction with the host, including: serum ferritin; immune complexes; acute phase proteins; isoenzymes; interleukin receptors; tumor necrosis factors, etc.

　　Third, tissue pathology examination

　　Microscopically, the tumor cells are aggregated into coarse string-like or cluster-like, separated by fine fibers, the cells are large, polygonal, the boundary is unclear, the cytoplasm is rich, containing obvious fine red granules, the nucleus is large or small, located in the center, the nucleolus is clear. The cytoplasmic granules are not mucus and not glycogen after special staining, but Sudan black B is positive, PAS staining after enzymatic digestion is still positive, indicating that it is very likely to be glycoprotein and have lipids, which supports the theory of its neurogenic tissue origin.

　　First, dietary principles of granular rhabdomyosarcoma of the vulva

　　1, Eat food rich in vitamin A. Such as egg yolk, animal liver (pigs, sheep, chickens, etc.), carrots, lettuce leaves, rapeseed, sweet potatoes, etc. The main function of vitamin A is to maintain the normal structure of epithelial tissues, stimulate the immune system of the body, mobilize the body's enthusiasm for anti-cancer, and resist pathogenic substances from entering the body.

　　2, More often choose food to increase immunity. Such as mushrooms, mushrooms, jujube, longan, lotus seeds, black fungus, tremella, etc.

　　3, Choose food with antitumor effects. Such as Danggui tea, cauliflower, turtle, Job's tears, lily, white radish, etc., these foods can improve the vitality of macrophages phagocytizing cancer cells, which is beneficial to anticancer.

　　4, Avoid eating food that is difficult to digest and spicy food. Such as fried, fried food and mustard, pepper, etc. Adopting a small meal, paying attention to the color, smell, and taste of dishes. Stimulate the appetite of patients. The cooking method of food, it is advisable to use steaming, boiling, stewing, and braising methods, in order to facilitate digestion and absorption.

　　Second, what is good for the body when eating granular rhabdomyosarcoma of the vulva

　　1,宜多吃具有抗恶性淋巴瘤作用的食物：穿山甲、蟾蜍、田鸡、芋艿。

　　2,淋巴结肿大宜吃荸荠、芋艿、核桃、荔枝、黄颡鱼、田螺、羊肚、猫肉、牡蛎。

　　3,发热宜吃豆腐渣、无花果、大麦、绿豆、苦瓜、节瓜、菱、水蛇。

　　4,盗汗宜吃猪心、羊肚、燕麦、高粱、豆腐皮。

　　Three, what is bad for the body when eating granular rhabdomyosarcoma of the vulva

　　1. Avoid coffee and other stimulating beverages.

　　2. Avoid scallion, garlic, ginger, cinnamon, and other spicy and irritating foods.

　　3. Avoid greasy, fried, moldy, and preserved foods.

　　4. Avoid chicken, pork head meat, and other stimulants.

　　5. Avoid seafood.

　　I. Prevention

　　1. Regular physical examination: To achieve early detection, early diagnosis, and early treatment.

　　2. Good follow-up: To prevent malignant transformation, follow-up work should be done after surgical resection.

　　3. Strengthen the physique, improve the body's immunity: Pay attention to the combination of work and rest, participate in physical exercise more often, and eat more fresh fruits and vegetables rich in vitamins.

　　II. Before treatment

　　It is necessary to have a detailed understanding of the symptoms of the disease and related contraindications.

　　III. Traditional Chinese medicine treatment methods for vulvar granulomatous myoblastoma

　　1. Principle:

　　Mainly to invigorate the body and nourish the blood, combine with clearing heat and detoxifying, to improve the body's immunity, promote the body's early recovery, and prevent postoperative infection. When the condition worsens, the role of traditional Chinese medicine is mainly to invigorate the body and nourish the blood, detoxify and anticancer, to adjust the body's immunity, consolidate the effect of surgical treatment, prolong survival, and improve the quality of life.

　　2. Formula:

　　(1) Modified Shiquan Dabu Decoction:

　　Angelica Sinensis 15g, Rehmannia 15g, White Peony 15g, Chuanxiong 10g, Codonopsis 15g, Atractylodes 10g, Poria 15g, Astragalus 30g, Cinnamon 5g, Amomum 5g, Lonicera 20g, Houttuynia 30g. Decocted for oral administration, one dose per day.

　　(2) Modified Baizhen Decoction:

　　Codonopsis 15g, Atractylodes 15g, Poria 15g, Angelica Sinensis 10g, Rehmannia 10g, Chuanxiong 10g, Red Peony 10g,山药15g, Astragalus 40g, Belamcanda 15g, Salvia Miltiorrhiza 15g, Lonicera 20g, Curcuma 15g, Semiaquilegia 15g. Decocted for oral administration, one dose per day.

　　IV. Western medical treatment methods for vulvar granulomatous myoblastoma

　　Surgical Treatment:Vulvar granulomatous myoblastoma is a benign tumor, but the tumor does not have a capsule, and granulomatous myoblastoma has the characteristic of extending and infiltrating into surrounding tissues. If the surgical resection is not thorough, it can recur. Therefore, the principle of treatment is to have an adequate surgical resection range. Therefore, a more extensive vulvectomy is necessary, but lymph node dissection is not required.