Objective: The aim of this study was to evaluate clinical manifestations, management options, and prognosis for women presenting with gestational trophoblastic tumors with vaginal metastasis.
Method: Fifty-one patients with vaginal metastases were analyzed retrospectively between January 1985 and September 2000. Vaginal metastasis were documented by physical examination and tissue biopsy.
Results: The incidence of vaginal metastasis in choriocarcinoma and invasive mole was 8.6 and 4.1%, respectively. The metastatic tumors were mostly located in the anterior wall of the lower part of vagina. Eighteen patients presented with hemorrhage and rupture. All patients were treated with 5-Fu combined chemotherapy. Vaginal packing was employed to stop bleeding in 16 patients. Three of them received selective angiographic embolization. Vaginal tumors disappeared after chemotherapy. Forty-four patients with complete remission were followed up periodically without evidence of recurrence.
Conclusions: Large or multiple vaginal metastases place the patients at high risk for significant hemorrhage. 5-Fu combined chemotherapy is still a reliable method for treating vaginal metastases. Angiographic embolization is emerging as a successful procedure to control the severe hemorrhage of vaginal tumors.