文献类型：期刊文献

英文题名：Primary vaginal adenocarcinoma as a radiation-associated secondary malignancy: A case report and comprehensive literature review

作者：Xing, Guangyang[1];Lu, Yani[2];Zhang, Cui[3];Sun, Xiaotong[1]

第一作者：Xing, Guangyang

通信作者：Sun, XT[1]

机构：[1]Gansu Prov Hosp, Dept Obstet & Gynecol, Lanzhou 730000, Gansu, Peoples R China;[2]Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou, Gansu, Peoples R China;[3]Gansu Univ Chinese Med, Affiliated Hosp, Dept Pathol, Lanzhou, Gansu, Peoples R China

第一机构：Gansu Prov Hosp, Dept Obstet & Gynecol, Lanzhou 730000, Gansu, Peoples R China

通信机构：[1]corresponding author), Gansu Prov Hosp, Dept Obstet & Gynecol, Lanzhou 730000, Gansu, Peoples R China.

年份：2025

卷号：104

期号：40

起止页码：e44272

外文期刊名：MEDICINE

收录：;Scopus(收录号：2-s2.0-105017949048);WOS:【SCI-EXPANDED(收录号:WOS:001588454100008)】；

基金：This work was financialy supported by the Hospital Research Fund of Gansu Provincial Hospital (24GSSYB-13) and Natural Science Foundation of Gansu Provincial Science and Technology Department (24JRRA597).

语种：英文

外文关键词：case report; immunohistochemical phenotype; non-DES-associated primary vaginal adenocarcinoma; post-chemoradiation carcinogenesis; radiation-induced secondary malignancy

摘要：Rationale:Primary vaginal adenocarcinoma (PVA) is an exceptionally rare malignancy, with most cases historically linked to in utero diethylstilbestrol (DES) exposure. Non-DES-associated PVA following definitive chemoradiotherapy for cervical cancer is extremely uncommon, and no standardized management protocol exists. This case illustrates a rare instance of radiation-associated PVA and highlights therapeutic considerations in previously irradiated pelvic fields.Patient concerns:A 53-year-old postmenopausal woman presented with intermittent vaginal bleeding occurring 5 years after radical hysterectomy and adjuvant chemoradiotherapy for stage IIA2 cervical squamous cell carcinoma.Diagnoses:Colposcopy-guided biopsies of the vaginal anterior wall revealed glandular architecture with cytological atypia. Immunohistochemistry demonstrated CK7(+), CK8/18(+), CEA(+), PAX8(-), ER(-), PR(-), p16 patchy weak negative, and wild-type p53. Systemic workup excluded metastatic disease, supporting the diagnosis of PVA (non-DES-associated, radiation-related).Interventions:In view of prior pelvic irradiation, the multidisciplinary team recommended dose-adjusted paclitaxel-cisplatin combination chemotherapy. Six cycles were administered, tailored to minimize cumulative toxicity.Outcomes:At 6-month follow-up, imaging studies confirmed complete clinical remission, with no locoregional recurrence or distant metastases.Lessons:This report underscores the potential for radiation-induced secondary vaginal adenocarcinoma in cervical cancer survivors, even after prolonged remission. Vigilant long-term surveillance, including annual vaginal cytology and targeted biopsies, is critical for early detection. Individualized therapeutic strategies - integrating prior treatment history, immunohistochemical profiling, and consideration of molecular alterations - are essential for optimizing outcomes in this rare patient population.