Benlghazi Abdelhamid, Belouad Moad, Hallak Mohammed, Benali Saad, Aitbouhou Rachid, Kouach Jaouad
Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Rabat, Morocco.
Int J Surg Case Rep. 2023 Sep;110:108657. doi: 10.1016/j.ijscr.2023.108657. Epub 2023 Aug 11.
Renal cell carcinoma (RCC) is a relatively uncommon malignancy, comprising only 3 % of adult cancers, but it is responsible for 85 % of primary renal tumors. When RCC metastasizes, the most common sites are the lungs, liver, bones, and brain. Although it is rare, RCC can also metastasize to the vagina. About 18-33 % of RCC cases are diagnosed with metastasis at the time of initial diagnosis.
A 48-year-old woman presented with postcoital bleeding and dyspareunia. At the physical examination, a polypoid mass was discovered on the right lateral wall of the upper third of her vagina and CT scan showed a right renal. Biopsies revealed clear cell renal carcinoma with metastasis to the vagina. The patient was diagnosed with stage IV (T3cN2 M1) renal cancer and underwent systemic therapy with Everolimus. However, subsequent imaging showed tumor progression, and the patient opted to halt treatment and was subsequently lost to follow-up.
In the past decade, there have been fewer than ten reported cases of RCC metastasizing to the vagina. Diagnosing vaginal clear cell carcinoma is challenging due to overlapping morphology with clear cell renal cell carcinoma, requiring immunohistochemistry. Treatment of vaginal cancers is challenging due to their rarity, and there is a lack of consensus on the optimal approach due to limited prospective studies.
Although the occurrence of RCC metastasis to the vagina is very uncommon, it is important to consider the possibility of metastatic RCC in cases of vaginal bleeding or lesions.
肾细胞癌（RCC）是一种相对不常见的恶性肿瘤，仅占成人癌症的3%，但却是原发性肾肿瘤的85%。当肾细胞癌发生转移时，最常见的部位是肺、肝、骨和脑。虽然罕见，但肾细胞癌也可转移至阴道。约18% - 33%的肾细胞癌病例在初诊时即被诊断为伴有转移。
一名48岁女性因性交后出血和性交困难就诊。体格检查时，在其阴道上段右侧壁发现一个息肉样肿物，CT扫描显示右肾有病变。活检显示为透明细胞肾细胞癌伴阴道转移。该患者被诊断为IV期（T3cN2 M1）肾癌，并接受了依维莫司的全身治疗。然而，后续影像学检查显示肿瘤进展，患者选择停止治疗，随后失访。
在过去十年中，报道的肾细胞癌转移至阴道的病例少于十例。由于阴道透明细胞癌与透明细胞肾细胞癌的形态学表现重叠，诊断具有挑战性，需要进行免疫组织化学检查。阴道癌的治疗具有挑战性，因其罕见，且由于前瞻性研究有限，对于最佳治疗方法缺乏共识。
虽然肾细胞癌转移至阴道的情况非常罕见，但在出现阴道出血或病变的病例中，考虑转移性肾细胞癌的可能性很重要。
