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Kwon SK, Yu CS, Lee SW, Kim J, Song I, Lee JL, Kim CW, Yoon YS, Park IJ, Lim SB, Kim JC. Isolated vaginal metastasis from stage I colon cancer: A case report. World J Clin Cases 2020; 8:527-534. [PMID: 32110662 PMCID: PMC7031836 DOI: 10.12998/wjcc.v8.i3.527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/12/2020] [Accepted: 01/18/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Distant metastasis occasionally occurs in patients who have been diagnosed with colorectal cancer (CRC), but it occurs in a few patients with stage I CRC. The vagina as a metastasis site has also been reported, albeit rarely. Most reported cases of vaginal metastasis (VM) report their origin from advanced CRC. We encountered a patient who was diagnosed with isolated VM originating from stage I colon cancer (T2N0) and herein present the case of this patient.
CASE SUMMARY A 63-year-old woman visited the outpatient clinic because of a positive result from a stool occult blood test. She underwent laparoscopic anterior resection and was pathologically diagnosed with stage I (T2N0) sigmoid colon cancer. Neither lymphovascular invasion nor perineural invasion was observed. Ten months following the surgery, isolated vaginal metastases were detected on gynecologic examination. The examination was performed due to vaginal spotting. A transvaginal wide excision was performed, and no other adjuvant treatment was provided after discussion with a multidisciplinary team and the patient. Subsequently, a new VM was discovered after 33 mo. An additional transvaginal excision was performed. To date, there has been no evidence of further disease progression. From the time of diagnosis of VM, the patient’s overall survival has been 54 mo.
CONCLUSION VM can occur as a result of early-stage colorectal cancer. Surgeons should consider the possibility of VM following complaints of gynecologic symptoms following surgery.
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Affiliation(s)
- Soon Keun Kwon
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Chang Sik Yu
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Shin-Wha Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Jihun Kim
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Inho Song
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Jong Lyul Lee
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Chan Wook Kim
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Yong Sik Yoon
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - In Ja Park
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Seok-Byung Lim
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
| | - Jin Cheon Kim
- Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
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Fadare O, Desouki MM, Gwin K, Hanley KZ, Jarboe EA, Liang SX, Quick CM, Rawish KR, Roma AA, Zheng W, Hecht JL, Parkash V, Osunkoya AO. Clear Cell Renal Cell Carcinoma Metastatic to the Gynecologic Tract: A Clinicopathologic Analysis of 17 Cases. Int J Gynecol Pathol 2018; 37:525-35. [DOI: 10.1097/pgp.0000000000000466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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D'Arco F, Pizzuti LM, Romano F, Natella V, Laccetti E, Storto G, Maurea S, Mainenti PP. MRI findings of a remote and isolated vaginal metastasis revealing an adenocarcinoma of the mid-sigmoid colon. Pol J Radiol 2014; 79:33-5. [PMID: 24567770 PMCID: PMC3930582 DOI: 10.12659/pjr.890032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 12/12/2013] [Indexed: 12/30/2022] Open
Abstract
A remote vaginal metastasis from a colo-rectal carcinoma is extremely rare. Only few cases have been described in the literature. The radiological appearances of a vaginal metastasis from colon-rectal cancer have not been extensively investigated. We report the MRI findings with clinical and pathological correlations of a remote and isolated vaginal metastasis revealing a mid-sigmoid adenocarcinoma in a 67 years old woman.
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Affiliation(s)
- Felice D'Arco
- Biomorphological and Functional Sciences, Section of Radiology, University of Naples "Federico II", Naples, Italy
| | - Laura Micol Pizzuti
- Institute of Biostructure and Bioimaging, Italian National Research Council, Naples, Italy
| | - Federica Romano
- Biomorphological and Functional Sciences, Section of Radiology, University of Naples "Federico II", Naples, Italy
| | - Valentina Natella
- Biomorphological and Functional Sciences, Section of Radiology, University of Naples "Federico II", Naples, Italy
| | - Ettore Laccetti
- Biomorphological and Functional Sciences, Section of Radiology, University of Naples "Federico II", Naples, Italy
| | | | - Simone Maurea
- Biomorphological and Functional Sciences, Section of Radiology, University of Naples "Federico II", Naples, Italy
| | - Pier Paolo Mainenti
- Institute of Biostructure and Bioimaging, Italian National Research Council, Naples, Italy
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Berhili S, El Khannoussi B, Kadiri S, Mezouri I, Bazine A, Touil A, El Khiyat I, Kebdani T, Benjaafar N. Uterine cervix metastasis from a sigmoid adenocarcinoma: a rare presentation of an uncommon tumor. Gynecol Oncol Res Pract 2014; 1:6. [PMID: 27231559 PMCID: PMC4878055 DOI: 10.1186/2053-6844-1-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 08/26/2014] [Indexed: 11/30/2022]
Abstract
Metastatic carcinoma to the uterine cervix from colorectal cancer, through haematogenous or lymphatic spread, is extremely rare. We report the case of a 59 year old woman in whom cervical metastasis was diagnosed after 13 months of follow-up for a sigmoid adenocarcinoma, confirmed by immunohistochemical study, with a review of the literature. This case illustrates that abnormal gynecologic symptoms can reveal a disease progression on patients who suffer colorectal cancer.
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Affiliation(s)
- Soufiane Berhili
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Basma El Khannoussi
- Laboratory of Cytopathology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Selma Kadiri
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Imane Mezouri
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Amine Bazine
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Asmae Touil
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Imane El Khiyat
- Laboratory of Cytopathology, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Tayeb Kebdani
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
| | - Noureddine Benjaafar
- Department of Radiotherapy, National Institute of Oncology, Ibn Sina University Hospital, Mohamed 5 Souissi University, Rabat, Morocco
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Narin R, Narin MA, Api M, Nazik H, Aytan H, Adamhasan F. Rare Metastasis of Colon Carcinoma Mimicking Endometrial Cancer. J Gynecol Surg 2013. [DOI: 10.1089/gyn.2012.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Raziye Narin
- Department of Obstetrics and Gynecology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Mehmet Ali Narin
- Department of Obstetrics and Gynecology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Murat Api
- Department of Obstetrics and Gynecology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Hakan Nazik
- Department of Obstetrics and Gynecology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Hakan Aytan
- Department of Obstetrics and Gynecology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Fulya Adamhasan
- Department of Pathology, Adana Numune Education and Research Hospital, Adana, Turkey
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Abstract
BACKGROUND Vaginal metastases originating from colorectal carcinoma are very rare. Due to the limited number of reported cases, there is no proposed standard treatment and little is known about its management outcome. AIM The aim of this article is to review the available literature to establish the clinical presentation, trends in treatment and prognosis of vaginal metastases from colorectal malignancy. METHODS A literature search using keywords used for database search were 'colorectal carcinoma', 'colorectal cancer', 'colon cancer' and 'vaginal metastasis'. RESULTS Of the 30 articles identified, 37 reported cases, were accessible for full evaluation. Cases reported originates from various countries and majority presented with vaginal bleeding. Diagnosis was established after histological examination and treatment options consist of surgical resection, radiotherapy or chemotherapy that have been used individually or in combination. Association with disseminated metastatic disease indicates ominous prognosis as seen in 32.4% (n = 12) cases. CONCLUSION Vaginal metastasis of colorectal cancer should be included in the differential diagnosis of a vaginal swelling. There is no proposed standard treatment for vaginal metastases but surgical resection is an appropriate approach for local control when no disseminated metastatic disease is documented.
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Affiliation(s)
- Hwei Jene Ng
- University of Aberdeen, Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom
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Zulfiqar M, Liu S, Shi D, Madan S, Jacques S, King L, Shidham V, Giorgadze T. Metastatic colorectal adenocarcinoma in cervicovaginal cytology specimens confirmed by immunocytochemical stains on liquid base specimens: Two study cases with review of the literature. Cytojournal 2013; 10:9. [PMID: 23858319 PMCID: PMC3709382 DOI: 10.4103/1742-6413.112297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 04/02/2013] [Indexed: 11/05/2022] Open
Abstract
Only a few cases of adenocarcinoma (ACA) metastatic to the female lower genital tract diagnosed on cervicovaginal Pap smear have been reported during the past several decades. Both conventional and liquid based cytology (LBC) have limited sensitivity and specificity in diagnosing metastatic disease and immunocytochemical (ICC) staining may be needed for confirming the diagnosis. We present two cases of metastatic colorectal ACA diagnosed on cervicovaginal ThinPrep (TP) Pap smears, with one confirmed by ICC staining method. Recognition of extra-uterine malignancy in the cervicovaginal cytology specimen is critical for the disease diagnosis, prognosis, and the treatment. ICC staining performed on the residual LBC specimen is an important methodology to confirm the diagnosis.
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Affiliation(s)
- Muhammad Zulfiqar
- Department of Pathology, Wayne State University, Detroit Medical Center, Karmanos Cancer Institute, MI, USA
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