Vaginal stump metastasis from sigmoid colon cancer

Acta Cytol. 2012;56(1):92-6. doi: 10.1159/000330815. Epub 2012 Jan 4.

Abstract

Background: Vaginal metastasis from organs other than the uterus is rare. Generally, patients with vaginal metastasis from colorectal cancer have a dismal prognosis. Although biopsy is the best method to make the diagnosis, massive bleeding may occur. On the other hand, liquid-based cytology (LBC) has the utility to perform immunocytochemistry on additional unstained slides: we can make a diagnosis with several immunocytochemical findings.

Case: A 67-year-old postmenopausal female presented to our hospital with vaginal bleeding. The patient had undergone colectomy because of her stage III sigmoid colon cancer 3 years earlier. The patient had also undergone hysterectomy for cervical cancer 30 years earlier. LBC from the vaginal stump revealed adenocarcinoma. Immunocytochemically, cancer cells were negative for cytokeratin 7 and positive for cytokeratin 20, which suggested metastasis from the sigmoid colon cancer; the diagnosis was made without a biopsy.

Conclusion: When the patient has a metastatic lesion from colon adenocarcinoma, LBC with immunocytochemistry is useful in making a diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / metabolism
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Aged
  • Biomarkers, Tumor / metabolism
  • Female
  • Humans
  • Hysterectomy
  • Immunohistochemistry / methods
  • Keratin-20 / metabolism
  • Keratin-7 / metabolism
  • Neoplasm Staging
  • Sigmoid Neoplasms / metabolism
  • Sigmoid Neoplasms / pathology*
  • Sigmoid Neoplasms / surgery
  • Vaginal Neoplasms / metabolism
  • Vaginal Neoplasms / secondary*

Substances

  • Biomarkers, Tumor
  • Keratin-20
  • Keratin-7