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Primary poorly differentiated carcinoma of the vagina with focal neuroendocrine differentiation: a tumour with aggressive behaviour
  1. Yi-Fan Mai1,2,
  2. I-San Chan2,3,
  3. Chiung-Ru Lai2,4 and
  4. Yi-Jen Chen3,5
  1. 1Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
  2. 2School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
  3. 3Department of Obstetrics and Gynaecology, Division of Gynaecology, Taipei Veterans General Hospital, Taipei, Taiwan
  4. 4Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  5. 5Institute of Clinical Medicine, Department of Obstetrics and Gynaecology, National Yang Ming Chiao Tung University, Taipei, Taiwan
  1. Correspondence to Dr Yi-Jen Chen; chenyj{at}nycu.edu.tw

Abstract

Primary vaginal neuroendocrine tumours are extremely rare but aggressive. We report a case of primary poorly differentiated vaginal carcinoma with focal neuroendocrine differentiation. The clinical stage was cT3N1M0, FIGO stage III. The patient received six cycles of cisplatin-based concurrent chemoradiation therapy (CCRT) followed by six cycles of adjuvant chemotherapy (IEP protocol: ifosfomide, epirubicin and cisplatin). Pelvic MRI scans obtained after treatment completion revealed no residual tumour in the vagina. However, the patient experienced severe dyspnoea 2 months later. Chest X-ray revealed a reticulonodular interstitial pattern over bilateral lungs with suspicion of lymphangitic carcinomatosis. Further chest, abdominal and pelvic CT scans showed bilateral lung metastases with multiple mediastinal, left lower neck and left axilla, intra-abdominal and pelvic lymphadenopathies. For this rare tumour, cisplatin-based CCRT followed by IEP protocol adjuvant chemotherapy may have a limited treatment effect. Further studies are necessary to provide more information on clinical management.

  • cancer intervention
  • obstetrics and gynaecology
  • cancer - see oncology

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Footnotes

  • Contributors Y-FM: drafted all parts of the case report and treat the patient in the ward at the time of initial diagnosis. I-SC: critically revised the draft. C-RL: contributed to the pathological analysis and discussion. Y-JC: managed the patient throughout, critically revised the draft, and finally approved the case report.

  • Funding This work was funded part by the Ministry of Science and Technology (grant number: MOST 109-2314-B-010 -041 -MY3 and MOST 109-2314-B-010-042 for YJC), Taipei Veterans General Hospital (grant number: V109C-097, V109EP-001, VN109-10, V110EP-001 and V110C-027 for YJC) and Szu-Yuan research foundation of internal medicine (grant number:109021;110012).

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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

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