Carcinoma colon masquerading as bleeding per vagina

Area of Science:

• Oncology
• Gastroenterology
• Gynecologic Oncology

Background:

• Vaginal metastasis from colorectal cancer is an infrequent occurrence.
• Typically, it signifies widespread disease and carries a poor prognosis.

Purpose of the Study:

• To report a case of isolated vaginal metastasis from colorectal cancer.
• To discuss the diagnostic and management strategies for this rare entity.

Main Methods:

• Case presentation of a patient with vaginal bleeding due to a vaginal lesion.
• Diagnostic workup included colonoscopy and Positron Emission Tomography-Computed Tomography (PET-CT).
• Management involved surgical resection of both the colonic primary and vaginal metastasis, followed by adjuvant chemotherapy and radiation therapy.

Main Results:

• The patient's vaginal lesion was confirmed as metastatic adenocarcinoma from a sigmoid colon primary.
• The patient underwent successful surgical management and adjuvant therapy.
• Limited literature suggests a reasonable survival for isolated vaginal metastasis amenable to surgical resection.

Conclusions:

• Vaginal metastasis should be considered in patients with vaginal bleeding, particularly those with a history of colorectal cancer.
• Isolated vaginal metastasis, when surgically resectable, may have a favorable prognosis.
• Treatment should be approached with curative intent within a multidisciplinary framework, similar to other oligometastatic conditions.