Guven S, Guvendag Guven E S, Ayhan A, Gokoz A
Department of Obstetrics and Gynecology and Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Int J Gynecol Cancer. 2005 Nov-Dec;15(6):1179-82. doi: 10.1111/j.1525-1438.2005.00172.x.
Recurrent carcinoma in situ in neovagina is rare, and the optimal modality of treatment is unclear. A 33-year-old multiparous woman was referred for vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, and cervical intraepithelial neoplasia, underwent skinning vulvectomy with perianal excision, total vaginectomy, vaginal hysterectomy, and vaginal reconstruction with split-thickness skin graft. Ten years after initial surgery, the recurrence as a high-grade intraepithelial neoplasia in the upper one third of neovagina was detected. For that reason, the upper one third of vaginectomy with at least 5-mm tumor-free border and vaginal reconstruction with split-thickness skin graft were performed. She has attended her regular follow-up for 3 years with no evidence of disease. All patients with vaginoplasty should undergo regular follow-up. This report is the seventh such report in English literature of patients previously treated for in situ carcinoma who later developed recurrence in the graft.
新阴道原位复发性癌罕见，最佳治疗方式尚不清楚。一名33岁经产妇因外阴上皮内瘤变、阴道上皮内瘤变和宫颈上皮内瘤变前来就诊，接受了外阴皮肤切除术加肛周切除术、全阴道切除术、经阴道子宫切除术以及分层皮片移植阴道重建术。初次手术后十年，在新阴道上三分之一处检测到高级别上皮内瘤变复发。因此，进行了上三分之一阴道切除术，切缘至少距肿瘤5毫米，并行分层皮片移植阴道重建术。她已定期随访3年，无疾病迹象。所有接受阴道成形术的患者均应定期随访。本报告是英文文献中第七例关于先前接受原位癌治疗后移植物出现复发的患者的报告。
