Songmen Swachchhanda, Nepal Pankaj, Fang Deborah, Lewis Eugene, Yagan Neda
St. Vincent's Medical Center, 2800 Main Street, Bridgeport, CT 06606, USA.
Radiol Case Rep. 2020 Jan 20;15(4):326-329. doi: 10.1016/j.radcr.2019.12.022. eCollection 2020 Apr.
Rectovaginal septum primary cancer is an extremely rare entity including gastrointestinal stromal tumor , adenocarcinoma (endometriosis related/unrelated) and Mullerian cell remnant cancer. These cancers are usually asymptomatic, but can grow large enough to present with pelvic discomfort or pressure symptoms (urinary retention or constipation). Imaging plays an important role in detection, characterization, staging workup and follow-up. Despite adenocarcinoma being the histology seen in most cases of primary rectovaginal septum carcinoma, 1 prior case of squamous cell cancer was reported in 2016. To the best of our knowledge, our case is the second reported case of this same extremely rare entity. We discuss a 35-year female with a rectovaginal mass which was detected by pelvic ultrasound, worked up by computed tomography (CT), positron emission tomography-CT and diagnosed by large incisional transvaginal biopsy. The patient underwent combined chemoradiotherapy, which resulted in complete resolution of the mass on follow up pelvic magnetic resonance imaging. Standard management guidelines are not available due to lack of adequate data.
直肠阴道隔原发性癌是一种极其罕见的疾病，包括胃肠道间质瘤、腺癌（与子宫内膜异位症相关/不相关）和苗勒管残余癌。这些癌症通常无症状，但可长得足够大，从而表现出盆腔不适或压迫症状（尿潴留或便秘）。影像学检查在检测、特征描述、分期评估和随访中起着重要作用。尽管腺癌是原发性直肠阴道隔癌大多数病例中的组织学表现，但2016年曾报道过1例鳞状细胞癌。据我们所知，我们的病例是同类极其罕见疾病的第二例报道。我们讨论了一名35岁女性，其直肠阴道肿物通过盆腔超声检测到，经计算机断层扫描（CT）、正电子发射断层扫描-CT评估，并通过经阴道大切口活检确诊。该患者接受了放化疗联合治疗，后续盆腔磁共振成像显示肿物完全消退。由于缺乏足够的数据，尚无标准的管理指南。
