Management of a case of primary vaginal cancer with irreducible massive uterine prolapse - a case report

Primary cancer of the vagina constitutes 1-2% of all malignant genital tract tumors in women. As one of the most complicated therapeutic problems in gynecological oncology, this disease had been deemed to be untreatable until the end of 1930s. Presently, as a result of technological improvements in radiotherapy and radical surgery, more favorable prognoses are known to be achieved even in advanced cases. In the present case, a woman with vaginal cancer and Stage IV massive uterovaginal prolapsus, which could not be repositioned under general anesthesia, was repositioned by surgical intervention prior to radiotherapy to avoid any potential vesicovaginal fistula formation. The cervix was bilaterally suspended to the pectineal ligaments by polypropylene mesh.

Primary vaginal cancer; Uterine prolapse; Vesicovaginal fistula

[1] Beller U., Sideri M., Maisonneuve P., Benedet J.L., Heintz A.P., Ngan H.Y. et al.: "Carcinoma of the vagina: 24th annual report on the results of treatment in gynecological cancer". J Epidemiol Biostat., 2001, 6, 141.

[2] Daling J.R., Madeleine M.M., Schwartz S.M., Shera K.A., Carter J.J., McKnight B. et al.: "A population-based study of squamous cell vaginal cancer: HPV and cofactors". Gynecol. Oneal., 2002, 84, 263.

[3] Hilborne L.H., Fu Y.S.: "Intraepithelial, invasive and metastatic neoplasms of the vagina". In: Wilkonson E.J. (ed.), "Pathology of the Vagina and Vulva". New York, Churchill Livingstone, 1987, 184.

[4] Fu Y.S.: "Pathology of the Uterine Cervix, Vagina and Vulva", 2nd edition, Philadelphia, Saunders, 2002, 531.

[5] Rao K., Kumar N.P., Geetha A.S.: "Primary carcinoma of vagina with uterine prolapse". J. Indian. Med. Assoc., 1989, 87, 10.

[6] Perez C.A., Arneson A.N., Dehner L.P., Galakatos A.: "Radiation therapy in carcinoma of the vagina". Obstet. Gynecol., 1974, 44, 862.

[7] DiSaia P.J., Creasman W.T.: "Invasive carcinoma of vagina and urethra". Clinical Gynecologic Oncology. 6'" edition, St. Louis, MO, Mosby, 2002, 241.

[8] Sun J.H., Zhang W.H., Li A.L., Wu A.R.: "Report on 114 primary vaginal carcinomas". Zhonghua Zhong Liu Za Zhi, 1987, 9, 457.