Published online Feb 6, 2020. doi: 10.12998/wjcc.v8.i3.527
Peer-review started: December 9, 2019
First decision: December 30, 2019
Revised: January 12, 2020
Accepted: January 19, 2020
Article in press: January 19, 2020
Published online: February 6, 2020
Processing time: 58 Days and 13.7 Hours
Distant metastasis occasionally occurs in patients who have been diagnosed with colorectal cancer (CRC), but it occurs in a few patients with stage I CRC. The vagina as a metastasis site has also been reported, albeit rarely. Most reported cases of vaginal metastasis (VM) report their origin from advanced CRC. We encountered a patient who was diagnosed with isolated VM originating from stage I colon cancer (T2N0) and herein present the case of this patient.
A 63-year-old woman visited the outpatient clinic because of a positive result from a stool occult blood test. She underwent laparoscopic anterior resection and was pathologically diagnosed with stage I (T2N0) sigmoid colon cancer. Neither lymphovascular invasion nor perineural invasion was observed. Ten months following the surgery, isolated vaginal metastases were detected on gynecologic examination. The examination was performed due to vaginal spotting. A transvaginal wide excision was performed, and no other adjuvant treatment was provided after discussion with a multidisciplinary team and the patient. Subsequently, a new VM was discovered after 33 mo. An additional transvaginal excision was performed. To date, there has been no evidence of further disease progression. From the time of diagnosis of VM, the patient’s overall survival has been 54 mo.
VM can occur as a result of early-stage colorectal cancer. Surgeons should consider the possibility of VM following complaints of gynecologic symptoms following surgery.
Core tip: Vaginal metastasis (VM) from colorectal cancer is rare. To our knowledge, this is the first case of VM from stage I colorectal cancer to be reported in English. Although the prognosis of VM is considered dismal, it seems to be favorable when it occurs isolated, without other metastases. The standard treatment has not yet been established because of rarity. The treatment needs to be established individually, and multidisciplinary teams can be helpful. Most patients with VM complain about gynecologic symptoms such as vaginal bleeding, so it should not be overlooked even in patient with stage I colorectal cancer.