Vaginal carcinoma in a young woman who underwent fertility-sparing treatment involving chemotherapy and conservative surgery

J Obstet Gynaecol Res. 2015 Jun;41(6):989-92. doi: 10.1111/jog.12638. Epub 2014 Dec 16.

Abstract

Vaginal carcinoma is a rare gynecological malignancy that is usually treated by radiation therapy and/or surgery combined with chemotherapy. Here, we report a case of invasive vaginal carcinoma in a young woman who underwent fertility-sparing treatment involving neoadjuvant chemotherapy and conservative surgery. A 36-year-old non-parous woman had a solid tumor in the vagina. Positron emission tomography/computed tomography showed a tumor in the vagina with high FDG uptake (SUV = 17.33) but no metastatic lesions. The patient was diagnosed with vaginal squamous cell carcinoma, FIGO stage I, T1N0M0. Because she wished to retain her fertility, neoadjuvant chemotherapy consisting of irinotecan hydrochloride and nedaplatin was initiated. After four courses of chemotherapy, partial vaginectomy was carried out and the pathological diagnosis of the residual lesion was VAIN 3. Following two further courses of the same chemotherapy, she obtained complete response, and has shown no evidence of disease for 14 months.

Keywords: chemotherapy; fertility-sparing treatment; squamous cell carcinoma; vaginal carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols
  • Camptothecin / analogs & derivatives
  • Camptothecin / therapeutic use
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / physiopathology
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Humans
  • Irinotecan
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Organ Sparing Treatments*
  • Organoplatinum Compounds / therapeutic use
  • Remission Induction
  • Uterine Hemorrhage / etiology
  • Uterine Hemorrhage / prevention & control
  • Vagina / drug effects
  • Vagina / pathology
  • Vagina / surgery*
  • Vaginal Neoplasms / drug therapy
  • Vaginal Neoplasms / pathology
  • Vaginal Neoplasms / physiopathology
  • Vaginal Neoplasms / surgery*

Substances

  • Organoplatinum Compounds
  • Irinotecan
  • nedaplatin
  • Camptothecin