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Non-diethylstilbestrol exposed vaginal adenocarcinoma in young patients associated with unilateral renal agenesis: two case reports and literature review

  • V. Plesinac-Karapandzic1,6,*,
  • S. Stojanovic Rundic1,6
  • R. Jankovic2
  • M. Nadrljanski3,6
  • XXX1
  • Z. Milovanovic4
  • A. Tomasevic1
  • N. Perisic Jeremic5

1Department of Radiotherapy, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia

2Department of Experimental Oncology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia

3Department of Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia

4Department of Pathology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia

5Department of Gynecological and Obstetrical Clinic "Narodni Front", Belgrade, Serbia

6School of Medicine, University of Belgrade, Serbia

DOI: 10.12892/ejgo3323.2017 Vol.38,Issue 1,February 2017 pp.157-161

Published: 10 February 2017

*Corresponding Author(s): V. Plesinac-Karapandzic E-mail: plesinacvesna@yahoo.com

Abstract

Background: Adenocarcinoma, accounts for up to14% of all vaginal cancer. In young patients, common histological feature is clear cell adenocarcinoma (CCA) while mesonephric adenocarcinoma (MA) is very rare. The authors report two patients in their early twenties with unilateral renal agenesis and vaginal adenocarcinoma not exposed to diethylstilbestrol (DES). Cases: Two patients with vaginal adenocarcinoma were treated, with external beam radiotherapy of pelvis combined with brachytherapy to a radical dose. In 2000, 25-year-old female, was admitted for radiotherapy after incomplete excision of the tumor localized in left vaginal apex and fornix. Histopathology confirmed CCA and classified as clinical Stage II. CT revealed left renal agenesis.The patient is alive and disease-free 15 years after therapy. Vaginal, urethral stenosis, and hydronephrosis occurred and ureteral stent was inserted. In the second patient, 22- year-old, in 2004, after biopsy of bulky tumor of vagina and histology, revealed MA in Stage III and CT scan also confirmed right renal agenesis. Radiotherapy was followed by chemotherapy. After 11 years, patient is disease-free with vaginal stenosis and incipient renal hydronephrosis. Conclusion: Radiotherapy is effective treatment in advance vaginal adenocarcinoma, however, with high morbidity. The authors advise rigorous gynecologic exams in young females with renal agenesis as there may be a risk of malignant changes in vagina.

Keywords

Vaginal adenocarcinoma; Renal agenesis; Radiotherapy.

Cite and Share

V. Plesinac-Karapandzic,S. Stojanovic Rundic,R. Jankovic,M. Nadrljanski,XXX,Z. Milovanovic,A. Tomasevic,N. Perisic Jeremic. Non-diethylstilbestrol exposed vaginal adenocarcinoma in young patients associated with unilateral renal agenesis: two case reports and literature review. European Journal of Gynaecological Oncology. 2017. 38(1);157-161.

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