An isolated vaginal metastasis from rectal cancer

Sadatomo, Ai; Koinuma, Koji; Horie, Hisanaga; Lefor, Alan Kawarai; Sata, Naohiro

doi:10.1016/j.amsu.2015.11.006

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…summarized the most common forms of presentation and symptoms of patients with vaginal tumours. Vaginal bleeding is by far the most common primary symptom in patients presenting either postmenopausal or postcoital [ 8 ]. Alongside this symptom, pelvic pain and the sensation of an intra-cavity mass are also common symptoms [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Metachronic distal rectovaginal septum metastasis with prior laparoscopic anterior resection for proximal rectal carcinoma

Tweed

Dam

Sosef

et al. 2023

Journal of Surgical Case Reports

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Metastatic disease in the vagina of other origins such as rectal cancer is rare and only very few cases have been reported. A female patient developed an isolated metachronic metastasis located at the lower part of the rectovaginal septum, 8 months after curative resection for proximal rectal cancer. An excision of the tumour was performed with primary closure of the vaginal wall. Histopathological examination confirmed the solid tumour to be metastatic disease from rectal origin with free margins. A year later, the patient received a lobectomy of the left lower lobe, due to distant metastasis of rectal origin 2 years after primary surgery. The patient is currently 4 years postoperatively, alive and shows no sign on recurrent disease. This case illustrates that awareness and early recognition of this rare presentation can lead to adequate treatment plans.

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Section: Discussionmentioning

confidence: 99%

Metachronic distal rectovaginal septum metastasis with prior laparoscopic anterior resection for proximal rectal carcinoma

Tweed

Dam

Sosef

et al. 2023

Journal of Surgical Case Reports

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“…However, in these case reports, the primary lesion often has been found. 6 Patients typically present with vaginal bleeding or discharge and a mass.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Section: Discussion/conclusionmentioning

confidence: 99%

“…2 Multi-modality therapy, including tri-modality approaches, have been explored in those with vaginal metastases from colorectal primaries with mixed results. 6 Extrapolation of data from primary vaginal cancer suggest a benefit to a combined chemoradiation followed by brachytherapy boost approach. 1 Multidisciplinary discussion is important to develop treatment plans as a combination of surgery, chemotherapy, and radiation, in our case appears to provide durable disease control.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Vaginal oligometastatic disease of colorectal primary: Report of a novel therapeutic approach

et al. 2021

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Vaginal oligometastatic disease of colorectal primary is a rare malignancy with few reported cases in the literature and no standardized treatment paradigm. We report on the definitive management of an unusual case of an elderly woman with the aforementioned disease. A 78-year-old African-American woman presented with vaginal spotting and was found to have a vaginal lesion. Final pathology was consistent with moderately differentiated adenocarcinoma of colorectal primary. Extensive work up, which included endoscopies, pathologic analyzes, and imaging workup, did not reveal a primary gastrointestinal malignancy. The patient underwent partial vaginectomy and final pathology once again confirmed moderately differentiated adenocarcinoma of colorectal primary (CDX 2 and CEA positive, ER/PR, and CK 7 negative) with negative margins. She went on to receive adjuvant concurrent chemoradiation with 5-FU based chemotherapy. She received 45 Gy in 25 fractions to the whole pelvis followed by an HDR brachytherapy boost to 12 Gy in two fractions. Unfortunately, 10 months after completing radiation, she was found to have adenocarcinoma arising from a hepatic flexure colon polyp on colonoscopy. She required definitive surgical resection and was staged as mpT3N0M1. She received 12 cycles of 5-FU and at 2-year follow-up was found to be disease free with no evidence of locoregional recurrence or distant metastatic disease. Continued long-term follow up is warranted.

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“…We searched PubMed, Medline and EMBASE to identify all articles published in the English language after 1960 and before Dec 31, 2018, pertaining to vaginal metastases from intestinal signet ring cell carcinoma. There are only a few previous reports of vaginal metastases from colorectal cancer in the literature, and the pathological type was not signet ring cell carcinoma [1]. Most of these patients usually had other metastatic lesions in locations such as the liver or breast.…”

Section: Introductionmentioning

confidence: 98%

An isolated vaginal metastasis from intestinal signet ring cell carcinoma: a case report and literature review

et al. 2020

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Background: Isolated vaginal metastases from intestinal signet ring cell carcinoma are extremely rare. There are no reported cases in the domestic or foreign literature. The characteristics of such cases of metastasis remain relatively unknown. As a life-threatening malignant tumor, it is very important to carry out a systemic tumor examination and transvaginal biopsy, even though clinical symptoms are not typical and there is no systemic tumor history. Case presentation: We present a case of an isolated vaginal metastasis from intestinal cancer in a 45-year-old female patient. The patient experienced a small amount of irregular vaginal bleeding and difficulty urinating. She had no history of systemic cancer. An early physical examination and transvaginal ultrasound (TVS) showed marked thickening of the entire vaginal wall. Pelvic nuclear magnetic resonance imaging (MRI) and a colposcopic biopsy were used to diagnose her with chronic vaginitis. An analysis of the vaginal wall biopsy showed signet ring cell carcinoma. Colorectal colonoscopy revealed advanced interstitial signet ring cell carcinoma as the primary source of vaginal wall infiltration. We review previous case reports of vaginal metastases from colorectal cancer and discuss the symptoms, pathological type, and outcomes. Conclusions: We hypothesize that vaginal wall thickening and stiffness accompanied by chronic inflammatory-like changes may be clinical features of a vaginal metastasis of signet ring cell carcinoma of the intestine. We also emphasize that it is very important to perform a systemic tumor examination in a timely manner when a patient has the abovementioned symptoms.

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An isolated vaginal metastasis from rectal cancer

Cited by 8 publications

References 8 publications

Metachronic distal rectovaginal septum metastasis with prior laparoscopic anterior resection for proximal rectal carcinoma

Metachronic distal rectovaginal septum metastasis with prior laparoscopic anterior resection for proximal rectal carcinoma

Vaginal oligometastatic disease of colorectal primary: Report of a novel therapeutic approach

An isolated vaginal metastasis from intestinal signet ring cell carcinoma: a case report and literature review

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