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Rare disease
CASE REPORT
Mesonephric adenocarcinoma of the vagina masquerading as a suburethral cyst
  1. Samar Shoeir1,
  2. Aswini Aparna Balachandran1,
  3. Jayson Wang2,
  4. Abdul H Sultan1
  1. 1Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK
  2. 2Histopathology, St George’s Hospital, London, UK
  1. Correspondence to Abdul H Sultan, abdulsultan{at}nhs.net

Summary

Mesonephric adenocarcinoma (MA) of the vagina is an extremely rare tumour of the female genital tract. There are currently 22 reported cases in the published literature. Consequently, its pathophysiology and disease progression remain poorly understood.

A 63-year-old woman presented with a history of a swelling in her vagina. Two-dimensional pelvic floor ultrasound and MRI demonstrated a multiloculated cyst with no malignant features. Initial workup provided a working diagnosis of a suburethral cyst. The diagnosis of MA was made on histology after excision of the cyst. Subsequent postoperative investigation showed no spread of the disease. The patient completed a course of prophylactic brachytherapy to prevent the possibility of any recurrence of disease. Due to its rarity, it remains difficult to diagnose MA of the vagina even on histological analysis. We would therefore recommend a low threshold to excise or perform tissue biopsy of unspecified vaginal masses.

  • cancer - see oncology
  • gynecological cancer
  • radiology (diagnostics)
  • urinary and genital tract disorders
  • ultrasonography

https://doi.org/10.1136/bcr-2018-224758

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    Footnotes

    • Contributors SS wrote the original drafts of the case report, coordinated between the team and contacted the patient to take her consent for publication. She did a provisional literature search on the mesonephric adenocarinoma of the vagina and followed guidance on corrections, revision and rewriting the case report answering the highlighted questions related to the accuracy of the content of the report. AAB revised the case report draft, corrected layout and rewrote the discussion. JW wrote the histopathology findings and how the diagnosis was made. AHS performed the ultrasound, conducted the surgery, supervised, guided and followed through the whole process of writing the article. He advised on how to perform a thorough literature search. He revised and agreed on the final case report content. All contributors revised the final copy of the case report and agreed on its content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.