Solitary vaginal metastasis as a presenting form of unsuspected renal adenocarcinoma

Vaginal bleeding may be the first clinical manifestation of an occult renal neoplasm. The renal adenocarcinoma is a tumor with a wide variety of presenting forms. Sometimes the clinical signs of the metastatic lesions are the first evidence of disease. The prevalence of solitary metastases at diagnosis is lower than 3%, and solitary vaginal metastasis from this tumor is rare. Histologically, this metastasis is indistinguishable from that of a primary vaginal mesonephric adenocarcinoma, making electron microscopy necessary for the differential diagnosis. Treatment consists of surgical removal of the renal neoplasm as well as the vaginal lesion.