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1332 Uncommon vaginal adenocarcinoma or metastatic tumor: a case report
  1. Gvantsa Kochiashvili1,2,
  2. Miranda Gudadze3,
  3. Tedo Jokharidze1,
  4. Irine Khubua1,
  5. Ana Khoperia1,
  6. NIno Sharashenidze1 and
  7. Archil Sharashenidze1,2
  1. 1Caucasus Medical Centre, Tbilisi, Georgia
  2. 2David Tvildiani Medical University, Tbilisi, Georgia
  3. 3Megalab, Tbilisi, Georgia


Introduction/Background Primary vaginal malignancies are notably rare, with squamous cell carcinoma (SCC) being the predominant histologic subtype, followed by adenocarcinoma (<15%). Vaginal metastases arising from colorectal carcinoma are a rare phenomenon. The scarcity of reported cases has led to a lack of established treatment standards, contributing to limited knowledge about the management outcomes in such cases.

Methodology A 72-year-old female presented with complaints of bloody vaginal discharge coinciding with urination and defecation, accompanied by lower back pain. Gynaecological examination revealed a tissue formation in the vaginal wall, measuring approximately 0.2–0.5 cm, which was biopsied for pathologic analysis.

Results Histopathological analysis revealed highly differentiated adenocarcinoma in the vaginal wall, suggestive of colorectal adenocarcinoma metastasis. Clinical correlation and radiological assessment were recommended. CT of the upper chest and abdomen showed no notable pathology, while pelvic MR tomography indicated invasion of the rectum by the vaginal wall. Colonoscopy revealed infiltrated mucosa in the anal canal, extending to the lower ampullary part, where a 1.8/1.2 cm infiltrated mucosa with a semi-dense texture was biopsied. Results are awaited.

Conclusion This case highlights the diagnostic complexities associated with rare vaginal adenocarcinomas, emphasising the importance of a multidisciplinary approach for precise diagnosis and treatment planning. The rarity and inherent diagnostic challenges, coupled with the necessity for various diagnostic methods, pose emotional and financial burdens on patients, often resulting in confusion and denial. Seeking second opinions, the patient awaits additional insights from comprehensive assessments, which unfortunately contributes to a delay in initiating timely treatment.

Disclosures The authors declare no conflicts of interest related to this case report.

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