A Case of Metachronous Solitary Vaginal Metastasis of Rectal Cancer Resected Radically

Abstract

The patient was a 69-year-old woman who had undergone laparoscopic low anterior resection for rectal cancer at the age of 66. Pathological findings revealed T3N0M0 Stage IIA and no adjuvant chemotherapy was conducted. Two years and seven months after the surgery, she presented to our hospital because of irregular vaginal bleeding, and a 3 cm-sized tumor that was adjacent to the external urethral opening was detected. Histopathologically the tumor was diagnosed as vaginal metastasis of rectal cancer. After confirming the absence of lymph node or other distant metastases by CT and MRI, we performed R0 resection of the tumor together with distal part of the urethra and cystostomy. The surgical margin was negative. We performed urethroplasty three months and removed vesical fistula four months after the surgery. She has been free from local recurrence or distant metastasis as of 1 year and 4 months after the surgery without adjuvant chemotherapy.

Although vaginal metastasis of colorectal cancer is rare and it frequently requires multivisceral resection due to anatomical reasons, long-term survival may be expected if R0 resection can be achieved.