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Donat SM, Sonoda Y, Al-Ahmadie H, Murali R, Ng DL, Funt SA, Park KJ. Evaluation of Women With a Positive Urine Cytology and no Demonstrable Disease in the Urinary Tract. Urology 2023; 173:10-16. [PMID: 36621649 PMCID: PMC10406391 DOI: 10.1016/j.urology.2022.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/08/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
Urinary cytology is indispensable both for the evaluation of gross hematuria and surveillance of patients with urothelial neoplasms. A positive urine cytology usually indicates the presence of urothelial carcinoma somewhere in the urinary tract. However, in women, it may also signal urothelial carcinoma involvement of the lower gynecologic tract or be the presenting sign for a primary cancer of the lower gynecologic tract or rectum. Guidelines for the evaluation of women with a positive cytology and normal urinary tract are lacking. We present a review of the current literature with case scenarios to bring clinicians attention to this diagnostic dilemma.
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Affiliation(s)
- Sherri M Donat
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY.
| | - Yukio Sonoda
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY
| | - Hikmat Al-Ahmadie
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rajmohan Murali
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Dianna L Ng
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samuel A Funt
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY
| | - Kay J Park
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Hermi A, Chakroun M, Saadi A, Saidani B, BelHadj Kacem L, Chebil M. Upper urinary tract urothelial carcinoma diagnosis by biopsy of a vaginal metastasis. Urol Case Rep 2022; 43:102114. [PMID: 35600810 PMCID: PMC9120260 DOI: 10.1016/j.eucr.2022.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 11/09/2022] Open
Abstract
Upper tract urothelial carcinoma presents 5% of urothelial cancers. The most frequent revealing symptom gross haematuria. Vaginal metastasis is rare revealing condition. The combination on these two symptoms should recall the diagnosis of this neoplasm. Biopsy of the vaginal mass can make the histologic diagnosis easily.
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Law ZW, Anbudurai M, Lee CSN, Lee LS. Vulvar urothelial carcinoma recurrence in an intact bladder free of disease. ANZ J Surg 2021; 92:1952-1954. [PMID: 34874090 DOI: 10.1111/ans.17415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/13/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Zhi Wei Law
- Department of Urology, Sengkang General Hospital, Singapore
| | - Manisha Anbudurai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Lui Shiong Lee
- Department of Urology, Sengkang General Hospital, Singapore
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Korkmaz M, Eryılmaz MK, Kerimoğlu Ü, Karaağaç M, Demirkıran A, Demir ET, Artaç M. Vaginal metastasis in solid tumours: our four cases and review of the literature. J Egypt Natl Canc Inst 2021; 33:3. [PMID: 33538929 DOI: 10.1186/s43046-021-00058-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaginal metastasis should be kept in mind when evaluating the staging tests of all cancers, especially endometrial cancer. CASE PRESENTATION We present four patients with vaginal recurrence who recently applied to our clinic. Three cases were of endometrial cancer and one case of rectal cancer. All patients presented with vaginal bleeding. CONCLUSION Standard treatment for vaginal metastasis has not yet been established. Therapeutic options for vaginal metastasis-separately or in combination-are surgical resection, radiotherapy, and chemotherapy.
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Affiliation(s)
- Mustafa Korkmaz
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey.
| | - Melek Karakurt Eryılmaz
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
| | - Ülkü Kerimoğlu
- Department of Radiology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Mustafa Karaağaç
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
| | - Aykut Demirkıran
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
| | - Emine Türen Demir
- Department of Department of Obstetrics and Gynecology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Mehmet Artaç
- Department of Medical Oncology, Necmettin Erbakan University School of Medicine, Akyokuş, 42080, Konya, Turkey
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Fedus T, Raś R, Książek M, Filipowska J, Kaznowska E, Skręt A, Skręt-Magierło J, Barnaś E. Primary vaginal squamous cell carcinoma with bladder involvement in uterine prolapsed patient: Case report. Medicine (Baltimore) 2017; 96:e8993. [PMID: 29390294 PMCID: PMC5815706 DOI: 10.1097/md.0000000000008993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Primary vaginal squamous cell carcinoma (SCC) is a rare disease. Primary SCC in prolapsed vagina is extremely rare. In the presented case additional bladder involvement was found. PATIENTS CONCERNS Primary vaginal SCC may be misinterpreted as decubitus in prolapsed vagina and it may delay proper diagnosis and treatment. DIAGNOSES Diagnosis was confirmed by the vaginal ulceration biopsy and cystoscopic biopsy of the involved bladder. INTERVENTIONS In the case presented percutaneous nephrostomy was the only possible treatment of hydronephrosis. OUTCOMES In advanced primary SCC (Figo IVA) with nodal involvement palliative treatment is only option. LESSONS Primary SCC mimicking decubitus which appeared in prolapsed vagina, may be accompanied by bladder involvement.
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Affiliation(s)
| | - Renata Raś
- Obstetrics and Gynecology Clinic, Frederick Chopin Clinical Provincial Hospital No 1
| | - Mariusz Książek
- Department of Patomorphology, Chair of Morphological Sciences, Faculty of Medicine
| | | | - Ewa Kaznowska
- Department of Patomorphology, Chair of Morphological Sciences, Faculty of Medicine
| | - Andrzej Skręt
- Obstetrics and Gynecology Clinic, Frederick Chopin Clinical Provincial Hospital No 1
| | - Joanna Skręt-Magierło
- Institute of Obstetrics and Emergency Medicine, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Edyta Barnaś
- Institute of Obstetrics and Emergency Medicine, Medical Faculty, University of Rzeszow, Rzeszow, Poland
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Aoun F, Kourie HR, El Rassy E, van Velthoven R. Bladder and vaginal transitional cell carcinoma: A case report. Oncol Lett 2016; 12:2181-2183. [PMID: 27602160 DOI: 10.3892/ol.2016.4894] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 11/20/2015] [Indexed: 11/05/2022] Open
Abstract
The involvement of the female genital tract in transitional cell carcinoma (TCC) has not been fully elucidated in women, although involvement is usually associated with a poor prognosis. The vagina, in particular, is considered to be the most commonly affected gynecological organ, with an incidence of 4% of total TCC cases. The pathogenesis of vaginal TCC is challenging to determine, although it is essential for the adequate management of the tumor and to determine the appropriate treatment. The present study reports a case of bladder TCC and metachronous vaginal TCC. The patient had a history of high risk non muscle invasive bladder cancer treated by BCG and presented with a recurrent carcinoma in situ. A novel cycle of BCG was initiated but the patient had a persistent disease and a palpable mass on bimanual examination. Radical anterior pelvectomy and bilateral pelvic and inguinal lymph node dissection was performed revealing the presence of TCC of the bladder neck and the invasion into the anterior vaginal wall. The differences between local vaginal invasion and the metastatic spread from a primary bladder TCC, the occurrence of a second primary vaginal tumor and the direct implantation of TCC via urine that contains transitional cancer cells were reviewed and analyzed. Finally, a management plan was determined.
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Affiliation(s)
- Fouad Aoun
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels 1000, Belgium
| | - Hampig Raphael Kourie
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels 1000, Belgium
| | - Elie El Rassy
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels 1000, Belgium
| | - Roland van Velthoven
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels 1000, Belgium
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Quaranta D, Delotte J, Bongain A, François E, Bereder JM, Bernard JL. [Vaginal metastasis revealing an adenocarcinoma of the transverse colon]. ACTA ACUST UNITED AC 2014; 42:622-5. [PMID: 25153435 DOI: 10.1016/j.gyobfe.2014.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/11/2014] [Indexed: 12/23/2022]
Abstract
Secondary localization to vagina had a severe prognosis, suggesting a disseminated metatastic disease. We report the case of prevalent vaginal metastasis of adenocarcinoma of the transverse colon. A 65 years old patient has consulted for vaginal mass. After delayed diagnosis, she presented with disseminated metastatic disease with peritoneal carcinomatosis. After neoadjuvant chemotherapy, the following treatment consisted of complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and vaginal adjuvant radiotherapy. No recurrence occurred after one year. Vaginal metastasis of colon cancer are rare. The dark prognosis might justify a systematic gynecological examination of women presenting colorectal neoplasy.
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Affiliation(s)
- D Quaranta
- Service de gynécologie, obstétrique, reproduction et de médecine fœtale, hôpital Archet II, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine de Ginestière, BP 3079, 06202 Nice cedex 3, France.
| | - J Delotte
- Service de gynécologie, obstétrique, reproduction et de médecine fœtale, hôpital Archet II, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine de Ginestière, BP 3079, 06202 Nice cedex 3, France
| | - A Bongain
- Service de gynécologie, obstétrique, reproduction et de médecine fœtale, hôpital Archet II, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine de Ginestière, BP 3079, 06202 Nice cedex 3, France
| | - E François
- Service de cancérologie digestive, centre Antoine-Lacassagne, 33 avenue de Valombrose, 06189 Nice cedex 2, France; Service de chirurgie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - J-M Bereder
- Service de chirurgie générale et cancérologie digestive, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France
| | - J-L Bernard
- Service de chirurgie générale et cancérologie digestive, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France
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Sabbagh C, Fuks D, Regimbeau JM, Degremont R, Jarry-Tossou V, Mauvais F. Isolated vaginal metastasis from rectal adenocarcinoma: a rare presentation. Colorectal Dis 2011; 13:e355-6. [PMID: 21689298 DOI: 10.1111/j.1463-1318.2011.02605.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- C Sabbagh
- Department of Digestive Surgery, Beauvais Hospital, Avenue Leon Blum, Beauvais Cedex, France
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Kaneko G, Kikuchi E, Hasegawa M, Miyajima A, Nakagawa K, Kameyama K, Oya M. Non-muscle invasive bladder cancer with concomitant vaginal urothelial carcinoma: a case report and review of the literature. Int J Clin Oncol 2010; 15:626-30. [PMID: 20544250 DOI: 10.1007/s10147-010-0097-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 05/13/2010] [Indexed: 12/01/2022]
Abstract
A 74-year-old female was referred to our hospital for non-muscle invasive bladder tumors initially treated at another hospital. Preoperatively, computed tomography and magnetic resonance imaging demonstrated non-muscle invasive bladder tumors and a vaginal tumor. A second transurethral resection of the bladder tumors, transvaginal tumor resection, and systemic chemotherapy were performed. The histopathological appearances of both tumors were very similar and the diagnoses were urothelial carcinoma (UC). The pathogenesis of the vaginal UC was considered to be the primary UC or metastasis from the bladder UC. Vaginal UC is extremely rare and this is only the 15th report in the literature.
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Affiliation(s)
- Gou Kaneko
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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