Aggressive Behavior of Warty Squamous Cell Carcinoma of the Vagina Associated with Uterine Prolapsed: Unusual Report

Abstract

Warty squamous cell carcinoma (WSCC), is a rare variant of squamous cell carcinoma that occurs mostly in younger women, but can occur in old women. It is due to human papillomavirus (HPV) infection. This rare entity has been described in several organs such as vulva, cervix, and penis. To the best of our knowledge WSCC of vagina associated with the third-degree of uterine prolapse has never been reported in the literature. We present an exceptional case of WSCC of vagina occurred in a 77-year-old woman with long disease duration. The physical exam found a large ulcer-budding lesion of the middle and lower third of the vagina that depends on the left vaginal wall. The full work-up concluded to stage IVA of FIGO classification, due to the bladder involvement. The patient underwent a hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic node dissection, left partial cystectomy with left ureteral reimplantation and total vaginectomy, followed by adjuvant radiotherapy. The patient had no recurrence during 8 years of regular follow-up. WSCC can express locally aggressive behavior, such we reported; despite it appears to be less aggressive than the typical well-differentiated squamous cell carcinoma. That leads to individualize WSCC from other verruciform neoplasms.

Pelvic organ prolapse and vaginal cancer: A systematic literature review

“…Specifically, an isolated partial colpectomy was performed in two cases 15,17 . Total vaginectomy plus radical hysterectomy plus bilateral pelvic or inguinal node dissection were performed in three cases 19,25,29 . Lastly, a carcinosarcoma was treated with Piver IV radical hysterectomy plus lymphadenectomy and omentectomy.…”

“…Overall, 21 studies met the inclusion criteria and were incorporated into the review process (Table 1). 1,2,5,6,13–29 The papers included mostly case reports and two small case series published from 1989 to 2020.…”

“…One book chapter and four papers did not deal with the topic of systematic review; one paper was a subsequent insight of a previously published paper; and three papers were excluded for being in languages other than 21 studies met the inclusion criteria and were incorporated into the review process (Table 1). 1,2,5,6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] The papers included mostly case reports and two small case series published from 1989 to 2020.…”