A case of alveolar soft part sarcoma with vaginal metastasis: successful control of vaginal bleeding with external beam irradiation

Causes and palliation of transfusion-associated vaginal bleeding in patients with metastatic cancer

PURPOSE

The current study was undertaken (1) to capture a clinically relevant, systematically collected series of patients with metastatic cancer and transfusion-associated vaginal bleeding and (2) to provide insight into how best to palliate this bleeding.

METHODS/RESULTS

As part of a single-institution review, 46 patients with metastatic cancer and transfusion-associated vaginal bleeding were identified. In a minority, 14 (30%), the cancer itself was directly responsible for the bleeding, and under these circumstances, gynecological cancer was the most frequent cause. In 13 patients (28%), more than 1 palliative intervention was attempted. Of all the interventions, a hysterectomy was performed most frequently and was successful in 11 patients. The use of ablation or embolization procedures was rarely tried but successful in 4 patients. However, 2 patients died of vaginal bleeding, despite multiple palliative procedures to control bleeding, including tumor embolization in one.

CONCLUSIONS

Transfusion-associated vaginal bleeding in patients with metastatic cancer can arise from nonmalignant causes and often assumes an uneventful course but can, at times, be serious and difficult to control.

An Unusual Case of Non-small Cell Lung Cancer Presenting with Renal Angle Pain and Hematuria

A 53-year-old woman was referred urgently to the urology department with a history of worsening right renal angle pain and associated hematuria. Further investigations revealed the presence of a primary non-small cell lung cancer (NSCLC) invading the posterior chest wall with an associated vaginal metastasis. To our knowledge, this is only the second case report in the literature of a vaginal metastasis from NSCLC.