RESUMO
Mesonephric adenocarcinoma (MA) of the vagina is an extremely rare tumour of the female genital tract. There are currently 22 reported cases in the published literature. Consequently, its pathophysiology and disease progression remain poorly understood.A 63-year-old woman presented with a history of a swelling in her vagina. Two-dimensional pelvic floor ultrasound and MRI demonstrated a multiloculated cyst with no malignant features. Initial workup provided a working diagnosis of a suburethral cyst. The diagnosis of MA was made on histology after excision of the cyst. Subsequent postoperative investigation showed no spread of the disease. The patient completed a course of prophylactic brachytherapy to prevent the possibility of any recurrence of disease. Due to its rarity, it remains difficult to diagnose MA of the vagina even on histological analysis. We would therefore recommend a low threshold to excise or perform tissue biopsy of unspecified vaginal masses.
Assuntos
Adenocarcinoma , Neoplasias Vaginais , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Biópsia , Braquiterapia , Feminino , Humanos , Imageamento Tridimensional , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Ultrassonografia , Neoplasias Vaginais/diagnóstico por imagem , Neoplasias Vaginais/patologia , Neoplasias Vaginais/terapia , Ductos Mesonéfricos/patologiaRESUMO
Breast carcinoma metastatic to the bladder is rare and accounts for approximately 3% of all secondary bladder neoplasms. We examine a case of breast cancer metastatic to the bladder with normal findings at cystoscopy. A 53-year-old woman with a history of breast carcinoma presented with a 6-month history of severe urgency and urgency incontinence. Treatment with multiple antimuscarinic therapies was unsuccessful. Vaginal examination demonstrated a non-mobile uterus with a suggestion of parametrial thickening. Urodynamic studies confirmed detrusor overactivity. CT showed a thickened bladder wall and cystoscopy revealed normal bladder mucosa with reduced bladder capacity. Bladder biopsies identified a poorly differentiated adenocarcinoma with strong oestrogen receptor staining. This was reported as a secondary deposit from a primary breast malignancy. The patient is currently under the care of the breast team and undergoing palliative chemotherapy.