Abstract
Background : Vaginal metastasis from other organ except uterus is rare. The majority of vaginal malignancies are metastatic, arising most commonly from other pelvic organs such as the ovaries and uterus. Vaginal metastasis from non-pelvic organ is rare. We herein report a case of pancreatic cancer metastasized to vaginal wall, which was diagnosed by cytology with immunocytochemistry.
Case : A 74-years-old female presented with vaginal bleeding. She had undergone a history of distal pancreatectomy and gastropylorectomy followed by chemotherapy with 6 courses of gemcitabin due to pancreatic tubal adenocarcinoma of, stage III (2 years earlier). The patient also had second line chemotherapy because CT showed recurrent mass metastatic tumor in the liver, 1 year after the surgery. Pelvic examination revealed small ulcer on vaginal wall. Liquid bqsed cytology (LBC) from this portion lesion revealed adenocarcinoma. Immunocytochemically, cancer cells were positive for cytokeratin 7 (CK7), CK20, carcinoembryonic antigen, and cancer antigen 19-9, which suggested metastasis from the pancreatic cancer ; the diagnosis was made without a biopsy.
Conclusion : When the patient has metastatic lesion and primary lesion can be expected from the medical history, LBC with immunocytochemistry is useful for making diagnosis.
