Has been post menopausal for 20 years. Clinical examination revealed a firm, nontender lump measuring 12 cms × 8 cms arising from the left labium major with smooth surface and well-defined margins (figure 1(a)). Ultrasonography (usg) revealed it to be a soft tissue mass with cystic areas involving left labium majus. There was no inguinal lymphadenopathy. generic viagra price comparisons Fine needle aspiration cytology (fnac) was inconclusive. Exploration through a longitudinal incision revealed a tumor above the adductor tendon but not fixed to it. jokes with viagra Tumor was dissected out completely and excised (figure 1(b)). Incision closed with a drain. Postoperative course was uneventful. Histopathology of the specimen showed a soft tissue sarcoma enveloped in a thick complete fibrous capsule (figure 2(a)). It consisted of lobules of oval or slightly elongated cells in rows, strands and sheets with intervening myxomatous stroma. The cells possessed deeply eosinophilic dense cytoplasm and large oval vesicular nuclei with nucleoli (figure 2(b)). generic viagra customer reviews Mitosis was rare. The amount of mucoid matrix varied from area to area but was in excess in some parts. viagra canada overnight delivery There was no capsular or vascular invasion. order viagra Hence, final diagnosis of myxoid chondrosarcoma was made. Patient refused adjuvant therapy. Followup of 1 year has shown her to be disease- and symptom- free. Figure 1: (a) preoperative picture showing soft tissue mass arising within left labium major. age men use viagra (b) encapsulated tumor after excision. viagra with insurance Figure 2: (a) encapsulated sarcomatous tumor (hematoxylin & eosin stain 80x). (b) single and small groups of vacuolated cells separated by abundant mucoid matrix (hematoxylin & eosin stain ccx). buy viagra online 3. Discussion esmc is a rare variety of sarcoma with a cytogenetic basis. The ews-chn gene fusion is seen in more than 75% cases of esmc [5]. viagra in canada without prescription It is seen more often in the lower extremities and buttocks, however case reports of esmc of orbit, shoulder, and upper extremity have been reported. This is seen more commonly in men and often asymptomatic [1]. viagra samples Our case was a 66-year-old female with lump arising from labium majus. viagra kwikmed frequently Preoperative diagnosis is difficult, however there are studies where fine needle aspiration cytology (fnac) has diagnosed this entity preoperatively [6]. Microscopically, extraskeletal myxoid chondrosarcoma has a multinodular pattern. The tumor nodules consist of round or slightly elongated cells of uniform shape and size in variable amounts of mucoid material. The neoplastic cells are arranged in short anastomosing cords or strands, and less frequently in small, loose aggregates. The individual cells have small hyperchromatic nuclei and a narrow rim of deeply eosinophilic cytoplasm and feature characteristic of chondroblasts [7]. Our case histopathology of the excised specimen confirmed the diagnosis. jokes with viagra Immunohistochemistry studies have shown that the tumor cells usually express vimentin, synaptophysin, s-10.