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Renal Cell Carcinoma With Solitary Vaginal Metastasis

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Renal Cell Carcinoma with Solitary Vaginal Metastasis Authors: University of Oklahoma Department of Urology Disclosure of conflict of interests: Abstract Background: Solitary vaginal metastasis of renal cell carcinoma is extremely rare. Case: We present a 71 year-old woman with a history of a stage T4,Nx,M1 renal cell carcinoma status post laparoscopic nephrectomy who presents with a vaginal mass. Imaging demonstrated a solid vaginal tumor suspicious for metastatic disease with no evidence of additional metastases. Excisional biopsy of the vaginal mass was consistent with renal cell carcinoma. Conclusions: Although rare, metastatic renal cell carcinoma can present as a solitary vaginal mass. Key Words: renal cell carcinoma, …show more content…

Further work up with computed tomography (CT) revealed a renal tumor (Figure 1.1) and a peri-urethral vaginal mass(Figure 1.2). The renal tumor was confirmed to be RCC, at which time she underwent a Laparoscopic Nephrectomy in February 2014. Subsequently she was referred to our service for evaluation of the vaginal mass. Figure 1.1 Figure 1.2 On examination in April 2014 Magnetic Resonance Imaging (MRI) was ordered to further characterize the vaginal mass. Pelvic T2 weighted MRI demonstrated a 2.3 x 2.5 x 2.9 cm mass infiltrating the right vaginal wall displacing the urethra to the left suspicious for metastatic disease (Figure 2.1). A positron emission tomography (PET) scan was ordered to evaluate for other possible locations of metastasis. PET scan revealed an unchanged vaginal mass and no evidence of additional metastasis (Figure 3.1). Excisional biopsy of the vaginal mass was consistent with metastatic RCC. Excisional biopsy of the cervix found no evidence of malignancy. Figure 2.1 Figure 3.1 At this point the patient was counseled about her options for proceeding. The patient elected to undergo a vaginal mass excision instead of a total vaginectomy despite the increased risk for recurrence. Subsequently the vaginal mass was excised and sent to pathology. Pathology revealed a 2.5 x 2 x 2 cm vaginal

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