Gidiri Muchabayiwa F, Nyakura M, Hukuimwe M, Magwali T, Makunike-Mutasa R, Museta F D
Academic Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, B-Floor, Old Health Sciences Building, Mazowe Street, Avondale, Harare, Zimbabwe.
Department of Histopathology, University of Zimbabwe College of Health Sciences, Mazowe Street, Avondale, Harare, Zimbabwe.
J Med Case Rep. 2017 Aug 22;11(1):232. doi: 10.1186/s13256-017-1399-8.
Metastatic vulval adenocarcinoma is a rare occurrence with only a few cases reported to date. They can arise from the breast, gastrointestinal system, or endometrium.
We present the case of a 55-year-old Black African woman who presented with vulval itching which progressed to warty lesions. Histology revealed a vulval adenocarcinoma which immunohistochemistry suggested was of gastrointestinal origin. Colonoscopy later confirmed an anorectal tumor as the primary site. Despite extensive chest metastases she looked surprisingly well and had no pulmonary symptoms. The major source of symptomatic distress was the itchy extensive warty lesions on her vulva. She has since had a vulvectomy which gave her significant symptomatic relief.
This case was interesting as vulval adenocarcinoma is a rare histological diagnosis found in less than 10% of vulval cancers. Primary vulval adenocarcinoma is rare with most of these cancers being secondary metastases from a distant site. Her symptoms were predominantly vulval with no chest symptoms even though she had extensive pulmonary metastases. She has been clinically well except for the itching suggesting an indolent course.
转移性外阴腺癌极为罕见，迄今为止仅有少数病例报道。其可起源于乳腺、胃肠道系统或子宫内膜。
我们报告一例55岁的非洲黑人女性，最初表现为外阴瘙痒，后进展为疣状病变。组织学检查显示为外阴腺癌，免疫组化提示其起源于胃肠道。随后的结肠镜检查证实原发性肿瘤位于肛管直肠。尽管存在广泛的肺部转移，但她看起来状态出奇地好，且没有肺部症状。主要的症状困扰是外阴广泛的疣状病变引起的瘙痒。她随后接受了外阴切除术，症状得到了显著缓解。
该病例很有意思，因为外阴腺癌是一种罕见的组织学诊断，在不到10%的外阴癌中发现。原发性外阴腺癌罕见，大多数此类癌症是远处部位的继发性转移。尽管她有广泛的肺部转移，但其症状主要在外阴，没有胸部症状。除了瘙痒外，她临床状况良好，提示病程进展缓慢。
