Bladder and vaginal transitional cell carcinoma: A case report

Abstract

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.

Clinical outcomes of transarterial chemotherapy and embolization for vaginal cancer

“…Vaginal transitional cell carcinoma is rare and aggressive, with a poor prognosis. The therapy is similar to that used for conventional squamous cell carcinoma . Small cell carcinoma of the vagina is an extremely rare cancer, although it is highly aggressive, no standard treatment has been established, and systemic relapse is an important issue .…”

Primary vaginal squamous cell carcinoma with bladder involvement in uterine prolapsed patient

“…Interestingly, the cases of reversed metastases from urogenital bladder cancer to the vagina have been reported in the literature. [ 21 – 26 ]…”

Vulvar urothelial carcinoma recurrence in an intact bladder free of disease

“…and Aoun et al . described patients with concurrent carcinoma‐ in‐situ of the bladder and urothelial carcinoma involving the anterior vaginal wall, where despite radical surgery, there remained a high rate of vulvar recurrence 6,7 …”

“…Reyes et al and Aoun et al described patients with concurrent carcinoma-in-situ of the bladder and urothelial carcinoma involving the anterior vaginal wall, where despite radical surgery, there remained a high rate of vulvar recurrence. 6,7 The pathogenesis of vulvar recurrence with urothelial cancer in patients treated with bladder preservation options may relate to tumour cell seeding or implantation during transurethral resection or micturition. 1,8 Apart from the implantation theory, bladder urothelial carcinoma may potentially metastasize to the vagina via the lymphatic or vascular system.…”