Primary intestinal-type adenoma of the vagina arising directly from endocervical-type adenosis: a case report

Tubular or villous adenomas are common neoplasms of the gastrointestinal tract. Other locations where these adenomas are found, including the female genital tract, are very rare. A literature review documents that only eight cases of tubular or villous adenomas found within the vagina have been published.

A 25-year-old, Caucasian woman presented with a history of primary infertility and postcoital bleeding. Gynecologic examination revealed a polypoid mass attached to the lateral wall of the vagina, approximately 2 cm above the introitus. The polypectomy specimen was a soft, tan, polypoid mass measuring 2 x 1 x 0.8 cm in size. Microscopically, the lesion was identical to pure tubular adenomas of the large intestine. Positive immunohistochemical staining for cytokeratin (CK) 20, CK 7, CEA and Cdx2 were identified.

An intestinal-type adenoma should be included in the differential diagnosis of a vaginal polypoid mass lesion in women. Our review of the literature presents the risk of malignant transformation.