Squamous cell vaginal cancer in a patient with complete pelvic organ prolapse – case report
Affiliation and adress for correspondence

1 Department of Surgical Gynecology, Karol Marcinkowski Medical University in Poznan, Head: Professor Stefan Sajdak, MD, PhD
2 Department of General, Endocrine Surgery, and Gastroenterological Oncology, Karol Marcinkowski Medical University in Poznan. Head: Professor Michał Drews, MD, PhD
Correspondence to: Department of Surgical Gynecology, Karol Marcinkowski Medical University in Poznan, Polna 33, 60-535 Poznan, tel.: +48 61 841 94 90, fax: +48 61 841 94 18, e-mail: kgo.ela@wp.pl
Research was carried out within the scope of services provided by the Department and was not funded from external sources.

Curr. Gynecol. Oncol. 2014, 12 (3), p. 233–238
DOI: 10.15557/CGO.2014.0021
ABSTRACT

Vaginal cancer is one of the least common reproductive tumors in women; in Poland it constitutes only 1–4% of them. It is found primarily in elderly patients with the mean age at diagnosis of approximately 70 years. Because of a similar clinical presentation and histological structure, vaginal cancer can be mistaken in its early stages for infiltrating cervical cancer. The incidence of vaginal cancer has been increasing at an alarming pace in recent years, due to the aging of the surveyed populations. In this article we analyzed the comorbidity of squamous cell vaginal cancer and complete pelvic organ prolapse. In order to employ proper cancer treatment, we had to restore the normal anatomy of the reproductive organs prior to brachytherapy. Following unsuccessful attempts to reduce the prolapse using a conservative approach, a two-stage surgical treatment was performed to enable brachytherapy. Initially, we excised the uterus with its adnexa and removed (with a rim of healthy tissue) the tumor in the pouch of Douglas. Subsequently, in collaboration with a surgical team, we reconstructed the vaginal ligaments with the use of a U-shaped polypropylene mesh, which was fixed to the sacral bone. Simultaneously, we reconstructed the rectovaginal septum. In connection with this case report we reviewed the current methods of surgical and systemic treatment of vaginal cancer.

Keywords: virginal squamous-cell cancer, enterocele, U-shaped polypropylene mesh, vaginal stub suspension, cancer recurrence