Introduction/Background Lung adenosquamous carcinoma (ASC) is a rare biphasic malignant tumor with squamous cell carcinoma (SCC) and adenocarcinoma (AC) components. ASC is reported to have an aggressive behavior, and the most common metastatic sites are the regional lymph nodes and surrounding areas. There have been no cases of ASC with vaginal metastasis reported in the living literature.

Methodology A 46-years-old woman was referred to the emergency department with a persistent dry cough. The patient underwent fibro-bronchoscopy and was diagnosed with an adenosquamous lung carcinoma. Other than pulmonary and lymphatic findings, a total body computed tomography (CT) examination highlighted a hypodense formation with a cystic appearance of about 9mm at the level of the vaginal region. A biopsy was performed in the posterior vaginal wall and highlighted a vaginal wall flap with subepithelial localization of neoplasia, compatible with pulmonary adenosquamous carcinoma known in the patient’s history.

Results The patient was subsequently taken in charge by oncologists and commenced medical therapy with Entrectinib. Four months after having begun the medical therapy, the patient manifested dyspnea, and high-resolution CT highlighted an increase of the pathological tissue determining bronchial occlusion. The patient underwent endobronchial stent placement and is currently closely monitored while re-starting therapy with Entrectinib, previously stopped because of the new symptoms.

Conclusion There has been only one case of vaginal metastasis from pulmonary tumor previously reported, and this is the first report of vaginal metastasis from ASC. Although extremely rare, the presence of such metastasis should be considered in women with suspects of vaginal neoformations.

Disclosures The authors declare no potential conflict of interest to report.