A Case of Advanced Rectal Cancer with Vaginal Invasion in a Woman with External Genital Malformation due to Sex Chromosome Abnormallities

Abstract

There are many surgical reports of rectal cancer invading the surrounding organs such as the vagina, uterus, bladder, and sacrum, but we have found no previous reports of surgery for rectal cancer in a patient with external genital malformation in Japan. A 50-year-old woman with sex chromosome abnormalities and external genital malformation presented with a type 2 tumor with vaginal invasion in the lower rectum. The tumor was large and had extensive invasion, so the patient underwent neoadjuvant chemotherapy followed by radical surgery. When deciding on the surgical procedures, consideration was given to the urinary and sexual functions because she had the external genital malformation and hypoplastic internal genitalia. With careful preoperative examination and investigation, we were able to safely perform laparoscopic rectal resection with resection of the posterior wall of the vagina in a woman with external genital malformation. Since rectal cancer with vaginal invasion in women with external genital malformations is rare, we report this case with some discussion.