Symptomatic vaginal bleeding in a postmenopausal woman revealing colon adenocarcinoma metastasizing exclusively to the vagina

Vaginal carcinomas are rare entities, accounting for 2% of all malignant cancers of the female genital tract, and the vast majority are metastatic. Adenocarcinoma of the colon metastasizing to the vagina is extremely rare, only 5 cases have been reported. We present the case of a woman who experienced vaginal bleeding as an isolated symptom of vaginal metastasis of colorectal adenocarcinoma. Vaginal localization of metastasis from colorectal cancer significantly worsens the survival prognosis, and a standard treatment has not yet been proposed. Potential mechanisms of spread of colorectal cancer to the vagina and therapeutic approaches are discussed. In this case, treatment included surgery and chemotherapy.     

Primary adenocarcinoma of the fallopian tube

Nineteen women with a mean age of 62 were treated for primary adenocarcinoma of the fallopian tube from 1960 to 1980. Common presentations were bleeding or discharge, pelvic mass, and pain. Cervical cytology was positive in five of eleven cases; endometrial curettings revealed adenocarcinoma in three of nine cases. Staging was by a system analogous to the International Federation of Gynecology and Obstetrics (FIGO) classification of ovarian carcinoma: 11% stage I, 44% stage II, 28% stage III, and 17% stage IV. Bleeding and abnormal cervical cytology were associated with earlier stage lesions and better prognosis. The most common treatment was excision of the primary tumor and gross intraperitoneal metastases. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed in 14 cases. Thirteen patients received 40-50 Gray of 2 MeV external beam pelvic radiation. Stages I and II had five-year survival of 100% and 63%. However, 38% of stage II patients had late extrapelvic relapses, and two early stage patients suffered serious complications of radiation therapy. All stage III and IV patients died of disease, 63% within the first 3 years. Based upon these results and review of other modern series, the importance of early diagnosis and complete surgical staging is emphasized, and stage-specific adjuvant therapy recommended.     

Primary adenocarcinoma of the fallopian tube

Primary carcinoma of the Fallopian tube is one of the rarest malignancies of the female genital tract. The Authors report a case of primary carcinoma of the uterine tube and review the treatment of this disease reported in literature. Since this tumor is so rare, debatable viewpoints remain and thus new proposals and modifications of methods of staging continue to emerge. The Authors conclude by suggesting that the setting up of a National Registry for collection of data available in Italy should be organized.     

Symptomatic vaginal bleeding in a postmenopausal woman: a case report of pancreatic adenocarcinoma metastasizing exclusively to the vagina

Although primary vaginal cancer is uncommon, representing 1-2% of all female genital malignancies, metastatic disease to the vagina is not. Most cases represent metastases from other pelvic organs or the colon. We present the second case in the literature of a pancreatic adenocarcinoma metastasizing exclusively to the vagina.     

Primary adenocarcinoma of the fallopian tube: a case report

We report a case of a 75-year-old postmenopausal woman with primary fallopian tube carcinoma confined to the left fallopian tube in Stage IA-2, who is alive without evidence of disease three years after total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, pelvic and paraaortic lymph node dissection were performed. Histopathological examination revealed a poorly differentiated (grade 3) papillary serous adenocarcinoma of the left fallopian tube. Adjuvant irradiation was given. Primary fallopian cancer should be suspected by clinicians even if the presenting symptoms are atypical and the primary treatment remains surgical resection followed by adjuvant chemotherapy or radiation. Appropriate therapy for each stage of the disease should be defined and new studies are needed to better depict the clinical course and prognostic factors.     

Cerebral metastasis from a primary adenocarcinoma of the fallopian tube

BACKGROUND: Primary adenocarcinoma of the fallopian tube is a rare disease, and cerebral metastasis from this tumor is an extremely rare event. CASE: A 61-year-old female, who had been thought to be in a disease-free state after the initial treatment for stage IIIc fallopian tube adenocarcinoma, presented with severe headache, dizziness, nausea, and vomiting. Brain CT and MRI revealed solitary metastatic lesion in the cerebrum, which was the only site of recurrence. It was removed surgically, followed by platinum-based combination chemotherapy, and a clinical remission was achieved for 36 months. CONCLUSION: Attention should be paid to the possibility of cerebral metastasis in patients who develop neurogenic signs and symptoms. Prolonged survival could be achieved with aggressive treatment containing surgical debulking and adjuvant chemotherapy for solitary cerebral metastasis.     

Combination chemotherapy in advanced adenocarcinoma of the fallopian tube

Advanced adenocarcinoma of the fallopian tube has a poor prognosis, with 5-year survival rates commonly less than 20%. Since 1980, we have managed 12 patients with disseminated tumor with combination chemotherapy following surgical cytoreduction. Analogous to the International Federation of Gynecology and Obstetrics staging of ovarian carcinoma, 3 patients were classified in Stage II, 8 in Stage III, and 1 in Stage IV. Ten patients received cisplatin-containing regimens. The 3 Stage II patients, without measurable disease after primary surgery, had an indeterminate response to chemotherapy. In Stages III-IV there were 4 complete responses (3 confirmed by second-look laparotomy) and 2 partial responses, for an overall response rate of 67%. Disease progressed in 2 patients and was stable in 1 patient. After median follow-up of 3.5 years, 4 of the Stage III-IV patients have no evidence of disease, 1 is alive with disease, and 4 are dead.     

Primary fallopian tube carcinoma in a 51-year-old postmenopausal woman--case report

The case of a 51-year-old woman with a primary carcinoma of the left fallopian tube is presented. Laparotomy performed for an ovarian tumour revealed that the patient had normal ovaries, but a left fallopian tube was dilated and filled with a tumour mass. Histopathological examination revealed primary adenosquamous cell carcinoma of the fallopian tube.     

Bilateral Brenner tumor with endometrial adenocarcinoma in a postmenopausal woman

Brenner tumor is a rare ovarian neoplasm which is generally monolateral, more rarely bilateral, and often associated with endometrial disorders related to oestrogenic production. However, there is no considerable evidence that the possible oestrogenic production of this tumor may be the cause of endometrial disorders. A case of bilateral Brenner tumor with endometrial adenocarcinoma in a postmenopausal woman is presented and the features are briefly discussed, with the conclusion that hormone-producing Brenner tumors may exert their promoter effect on the development of endometrial carcinoma causing an imbalance in the oestrogen and progesterone ratio rather than producing a large amount of oestrogen.     

Clear cell adenocarcinoma of the vagina: a second primary in a diethylstilbestrol-exposed woman?

A clear cell adenocarcinoma of the vaginal remnant in a diethylstilbestrol (DES)-exposed woman developed 20 years after anterior exenteration for a histologically similar stage II vaginal cancer. Arguments favoring a new primary cancer over a late recurrence are presented. This case probably represents the first report of a second primary vaginal clear cell cancer after DES exposure in utero. The implications of a second vaginal primary and the need for long-term surveillance in DES-exposed women are discussed.     

Sister Mary Joseph's nodule as the first presenting sign of primary fallopian tube adenocarcinoma

Umbilical metastasis (Sister Mary Joseph's nodule) is often the first sign of intraabdominal and/or pelvic carcinoma. We describe the fourth case reported in the literature of Sister Mary Joseph's nodule originating from fallopian tube carcinoma. In a 54-year-old woman, Sister Mary Joseph's nodule was unexpectedly detected during umbilical hernia repair. Subsequent laparoscopy revealed a 2-cm friable tumor located at the fimbriated end of right fallopian tube and 1-cm peritoneal implant in the pouch of Douglas. Laparoscopic bilateral adnexectomy and resection of the peritoneal implant were performed. Because frozen section examination revealed fallopian tube carcinoma, the procedure was continued with laparotomy including total abdominal hysterectomy, omentectomy, and pelvic lymph node sampling. Final diagnosis was stage IIIB fallopian tube carcinoma. The patient received postoperative adjuvant chemotherapy with single-agent carboplatin and has remained alive and with no evidence of disease. It is concluded that in cases of Sister Mary Joseph's nodule, laparoscopy can be a useful tool in the search of the primary tumor in the abdomen and/or pelvis. Laparoscopy can provide crucial information with respect to the location, size, and feasibility of optimal surgical resection of the intraabdominal and/or pelvic tumors.     

Posthysterectomy carcinoma of the fallopian tube presenting as vaginal adenocarcinoma: A case report

The clinical and pathological features of a case of adenocarcinoma of the fallopian tube with a unique presentation are described. The 68-year-old patient presented with vaginal bleeding 25 years after a vaginal hysterectomy. Pelvic examination revealed a 0.5-cm nodule of tumor involving the mucosa of the vaginal apex. At laparoscopy, the left fallopian tube was dilated and adherent to the vaginal vault. Pathological examination of the upper vaginectomy and bilateral salpingo-oophorectomy specimen revealed a primary papillary adenocarcinoma of the left fallopian tube that had invaded directly into the mucosa of the vaginal apex. Vaginal involvement, either at the time of presentation or subsequently in the course of the disease, is very rare in patients with carcinoma of the fallopian tube.     

A case report of primary adenocarcinoma of the fallopian tube

The apparently smallest primary adenocarcinoma (2.3 mm in diameter) of the fallopian tube ever described was diagnosed by repeated blind sectioning of the surgical specimen after the preoperative finding of an abnormal cervical Papanicolaou smear and the subsequent finding of abnormal cells in fluid obtained by laparoscopic peritoneal lavage, although a survey of the patient for a primary cancer was negative.