Obstet Gynecol Sci.  2013 Nov;56(6):416-419. 10.5468/ogs.2013.56.6.416.

Vaginal cancer with multiple liver and pulmonary metastases that achieved long-term survival

• Kim JY
• Lee KA
• Kim BG
• Bae DS
• Lee JW

• KMID: 1500378
• DOI: http://doi.org/10.5468/ogs.2013.56.6.416

Abstract

Primary vaginal cancer represents only 1% to 2% of malignant neoplasm of the female genital tract. Here, we report a 68-year-old woman who showed a vaginal tumor extending to urethra and clitoris, a 10 cm-sized mass in left adnexa and multiple metastases in lung and liver. Vaginal biopsy showed squamous cell carcinoma of vagina and she was diagnosed as International Federation of Gynecology and Obstetrics stage IVB vaginal cancer. Palliative surgery including left salpingectomy, tumorectomy, and clitoris mass excision was performed. Concurrent chemoradiation therapy (CCRT) with six cycles of 5-fluorouracil and cisplatin was administered. The patient had a complete remission of 20 months after treatment. At a 40-month follow-up, there was no evidence of local recurrence or distant metastasis. We can suggest that CCRT is very effective in treating primary squamous cell carcinoma of the vagina, not only in locally advanced but also systemically involved vaginal cancer in selected cases.

Keyword

Chemoradiotherapy; Metastasis; Vaginal Neoplasms

MeSH Terms

Aged
Biopsy
Carcinoma, Squamous Cell
Chemoradiotherapy
Cisplatin
Clitoris
Female
Fluorouracil
Follow-Up Studies
Humans
Liver
Lung
Neoplasm Metastasis*
Palliative Care
Salpingectomy
Survivors*
Urethra
Vagina
Vaginal Neoplasms*
Cisplatin
Fluorouracil

Figure

• 

  Fig. 1 (A) Computed tomography (CT) image of the pelvis before treatment shows invasion of vaginal tumor into the clitoris (arrows), metastatic tumor in ovary (dotted arrow) and uterus. The solid arrows indicate vaginal tumor invading clitoris. The dotted arrows indicate metastatic tumor invading adnexa and uterus. (B) Multiple metastatic nodules in both lungs on chest CT. (C) Multiple hepatic metastasis in abdomen and pelvis CT.

• 

  Fig. 2 (A) Abdomen & pelvis (AP)-computed tomography (CT) taken one month after CCRT shows a complete disappearance of tumor in vagina. (B) Multiple metastatic nodules in both lungs have completely disappeared after CCRT. (C) After 20 months of treatment, AP-CT reveals a complete disappearance of multiple hepatic metastases. CCRT, concurrent chemoradiation therapy.

Reference

1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005; 55:74–108.

2. Hacker NF, Eifel PJ, van der Velden J. Cancer of the vagina. Int J Gynaecol Obstet. 2012; 119:Suppl 2. S97–S99.

3. Dalrymple JL, Russell AH, Lee SW, Scudder SA, Leiserowitz GS, Kinney WK, et al. Chemoradiation for primary invasive squamous carcinoma of the vagina. Int J Gynecol Cancer. 2004; 14:110–117.

4. Beller U, Benedet JL, Creasman WT, Ngan HY, Quinn MA, Maisonneuve P, et al. Carcinoma of the vagina. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006; 95:Suppl 1. S29–S42.

5. Creasman WT, Phillips JL, Menck HR. The National Cancer Data Base report on cancer of the vagina. Cancer. 1998; 83:1033–1040.

6. Di Donato V, Bellati F, Fischetti M, Plotti F, Perniola G, Panici PB. Vaginal cancer. Crit Rev Oncol Hematol. 2012; 81:286–295.

7. Gallup DG, Talledo OE, Shah KJ, Hayes C. Invasive squamous cell carcinoma of the vagina: a 14-year study. Obstet Gynecol. 1987; 69:782–785.

8. Frank SJ, Jhingran A, Levenback C, Eifel PJ. Definitive radiation therapy for squamous cell carcinoma of the vagina. Int J Radiat Oncol Biol Phys. 2005; 62:138–147.

9. Kirkbride P, Fyles A, Rawlings GA, Manchul L, Levin W, Murphy KJ, et al. Carcinoma of the vagina: experience at the Princess Margaret Hospital (1974-1989). Gynecol Oncol. 1995; 56:435–443.

10. Holleboom CA, Kock HC, Nijs AM, Leers WH. cis-Diaminechloroplatinum in the treatment of advanced primary squamous cell carcinoma of the vaginal wall: a case report. Gynecol Oncol. 1987; 27:110–115.

11. Nashiro T, Yagi C, Hirakawa M, Inamine M, Nagai Y, Sakumoto K, et al. Concurrent chemoradiation for locally advanced squamous cell carcinoma of the vagina: case series and literature review. Int J Clin Oncol. 2008; 13:335–339.