Introduction/Background To present the clinical image and clinical video of a total pelvic exenteration for relapsed

Methodology The patient’s medical history and laboratory, imaging and histopathological reports were reviewed in order to comprehensively present the diagnostic approach and course of treatment.

Results A 38 year old woman with locally advanced vaginal cancer initially treated with combined chemo-radiation therapy (25 cycles of radiation with concurrent cisplatin), one month later was presented vaginal bleeding. As further treatment cauterization of vaginal lesions was performed followed by brachytherapy. Six months later, during her follow-up period, the patient performed imaging tests where a suspicious lesion in upper vagina was found in Magnetic Resonance Imaging (MRI). The patient sought consultation from the gynecologic oncology team of our ESGO certified Department, where a biopsy was perfomed which confirmed the presence of residual disease. The case was discussed in our Multidisciplinary Tumour Board as per protocol and a treatment with 6 cycles of chemotherapy (carboplatin/paclitaxel) was decided. 3 months later she presented again to our Department with an ulceration in vulva and vagina, and a new biopsy confirmed the presence of residual disease. As a result, after thorough consideration and detailed consultation to the patient, a pelvic exenteration with an appendectomy, vaginal excision, end-colostomy and ureterostomy was performed.

Conclusion Total pelvic exenteration is an ultraradical demanding surgical procedure, which may in certain cases be the only remaining therapeutic solution. Relapsed vaginal cancer may consist a relative indication.

Disclosures Authors have nothing to disclose.