Background: Carcinoma of the neovagina is extremely rare, and only one other case has been reported after sex-reassignment surgery. Malignancies seem to be dependent on the original tissue and are thought to be associated with HPV infection or chronic irritation.
Case Report: A 53-year-old male-to-female transsexual presented 21 years after initial surgery with vaginal discharge that was found to be due to a moderately differentiated squamous cell carcinoma. She was treated with chemoradiation with disease remission; however, she had significant stenosis and narrowing of the neovagina.
Comment: The optimum treatment is unclear, although radiation seems to be the most common technique with surgery an alternative. All patients should have regular clinical follow-up provided by a primary treating unit, which includes pelvic examination and cytologic smears. As a minimum, follow-up should occur as per other vaginal malignancies for at least 10 years.