Background: Here, we report the case of a patient with endometrial carcinoma stage IB who was diagnosed with squamous cell carcinoma of the vaginal vault 10 years after radiotherapy. Case: A 55-year-old female patient with endometrial carcinoma FIGO stage IB received pelvic irradiation and underwent surgery for her disease. After 10 years, she experienced vaginal bleeding and was subsequently diagnosed with squamous cell carcinoma of the vaginal vault. No distant metastases were identified and the patient was not a candidate for surgery. She received chemotherapy using a combination of 5-fluoruracil and cisplatin, but it was ineffective. The patient is still alive with a progressive disease. Conclusion: Long-term follow-up and aggressive investigation, which even include tissue biopsy, are mandatory whenever patients with a past medical history of pelvic irradiation experience any pelvic symptoms in order to detect early occult second malignancies. (J GYNECOL SURG 29:56)
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References
1.
LandisSH, MurrayT, BoldenS, WingoPA. Cancer statistics, 1999. Cancer Stat, 1999; 49:8.
2.
ChaturvediAK, EngelsEA, GilbertESet al.Second cancers among 104,760 survivors of cervical cancer: evaluation of long-term risk. J Natl Cancer Inst, 2007; 99:1634.
3.
SeidmanJD, KumarD, CosinJAet al.Carcinomas of the female genital tract occurring after pelvic irradiation: a report of 15 cases. Int J Gynecol Pathol, 2006; 25:296.
4.
LoriganJG, LibshitzHI, PeuchotM. Radiation-induced sarcoma of bone: CT findings in 19 cases. AJR Am J Roentgenol, 1989; 153:791.
5.
BuchholzTA. Lung carcinoma development after radiotherapy for breast carcinoma. Cancer, 2003; 98:1331.
6.
TravisLB, HillDA, DoresGMet al.Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease. JAMA, 2003; 290:465.
7.
AcharyaS, SarafoglouK, LaQuagliaMet al.Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence. Cancer, 2003; 97:2397.
8.
KleinermanRA, CurtisRE, Boice JDJret al.Second cancers following radiotherapy for cervical cancer. J Natl Cancer Inst, 1982; 69:1027.
9.
BealKP, SinghB, KrausDet al.Radiation-induced salivary gland tumors: a report of 18 cases and a review of the literature. Cancer J, 2003; 9:467.
10.
PrideGL, BuchlerDA. Carcinoma of the vagina 10 or more years following pelvic irradiation therapy. Am J Obstet Gynecol, 1977; 127:513.
11.
EvansHS, NewnhamA, HodgsonSVet al.Second primary cancers after cervical intraepithelial neoplasia III and invasive cervical cancer in Southeast England. Gynecol Oncol, 2003; 90:131.
12.
BoiceJDJr, DayNE, AndersonA. Second cancers following radiation treatment for cervical cancer: an international collaboration among cancer registries. J Natl Cancer Inst, 1985; 74:955.
13.
ChooYC, AndersonDG. Neoplasms of the vagina following cervical carcinoma. Gynecol Oncol, 1982; 14:125.
14.
MuradTM, DurantJR, MaddoxWAet al.The pathologic behavior of primary vaginal carcinoma and its relationship to cervical cancer. Cancer, 1975; 35:787.
15.
HoffmanM, RobertsSW, CavanaghD. Second pelvic malignancies following radiation therapy for cervical cancer. Obstet Gynecol Surv, 1985; 40:611.
16.
BehtashN, TehranianA, ArdalanFAet al.Uterine papillary serous carcinoma after pelvic radiation therapy for cancer of the cervix. J Obstet Gynaecol, 2002; 22:96.
17.
HagiwaraT, MoriT, KakuT. Development of endometrial cancer following radiation therapy for cervical carcinoma. Eur J Gynaecol Oncol, 2005; 26:191.
18.
GuptaVK, HoekstraA. Type I endometrial cancer after chemoradiation therapy for carcinoma of the cervix: a case report. Open J Obstet Gynecol, 2011; 1:225.
19.
ParkashV, CarcangiuML. Uterine papillary serous carcinoma after radiation therapy for carcinoma of cervix. Cancer, 1992; 69:496.
20.
ShengX, SunJ, ZhouC. The clinical evaluation of endometrial carcinoma following irradiation for cervical cancer. Zhonghua Fu Chan Ke Za Zhi, 1998; 33:553.
21.
SenkusE, KonefkaT, NowaczykMet al.Second lower genital tract squamous cell carcinoma following cervical cancer: a clinical study of 46 patients. Acta Obstet Gynecol Scand, 2000; 79:765.
22.
PothuriB, RamondettaL, MartinoMet al.Development of endometrial cancer after radiation treatment for cervical carcinoma. Obstet Gynecol, 2003; 101:941.
