The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
BMC Cancer. 2020 May 27;20(1):478. doi: 10.1186/s12885-020-06950-x.
Isolated vaginal metastases from intestinal signet ring cell carcinoma are extremely rare. There are no reported cases in the domestic or foreign literature. The characteristics of such cases of metastasis remain relatively unknown. As a life-threatening malignant tumor, it is very important to carry out a systemic tumor examination and transvaginal biopsy, even though clinical symptoms are not typical and there is no systemic tumor history.
We present a case of an isolated vaginal metastasis from intestinal cancer in a 45-year-old female patient. The patient experienced a small amount of irregular vaginal bleeding and difficulty urinating. She had no history of systemic cancer. An early physical examination and transvaginal ultrasound (TVS) showed marked thickening of the entire vaginal wall. Pelvic nuclear magnetic resonance imaging (MRI) and a colposcopic biopsy were used to diagnose her with chronic vaginitis. An analysis of the vaginal wall biopsy showed signet ring cell carcinoma. Colorectal colonoscopy revealed advanced interstitial signet ring cell carcinoma as the primary source of vaginal wall infiltration. We review previous case reports of vaginal metastases from colorectal cancer and discuss the symptoms, pathological type, and outcomes.
We hypothesize that vaginal wall thickening and stiffness accompanied by chronic inflammatory-like changes may be clinical features of a vaginal metastasis of signet ring cell carcinoma of the intestine. We also emphasize that it is very important to perform a systemic tumor examination in a timely manner when a patient has the abovementioned symptoms.
孤立性阴道转移来自肠印戒细胞癌极为罕见。国内外文献均未见报道。此类转移病例的特征仍知之甚少。作为一种危及生命的恶性肿瘤,即使临床症状不典型且无全身肿瘤史,进行系统的肿瘤检查和阴道活检非常重要。
我们报告了一例 45 岁女性患者的孤立性阴道转移癌。患者经历了少量不规则阴道出血和排尿困难。她没有全身癌症病史。早期的体格检查和阴道超声(TVS)显示整个阴道壁明显增厚。盆腔磁共振成像(MRI)和阴道镜活检诊断为慢性阴道炎。阴道壁活检分析显示印戒细胞癌。结肠镜检查显示晚期间质性印戒细胞癌是阴道壁浸润的主要来源。我们回顾了先前关于结直肠癌阴道转移的病例报告,并讨论了症状、病理类型和结局。
我们假设阴道壁增厚和僵硬伴有慢性炎症样变化可能是肠印戒细胞癌阴道转移的临床特征。我们还强调,当患者出现上述症状时,及时进行全身肿瘤检查非常重要。