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Carcinoma of the Neovagina After Male-to-Female Reassignment

Fernandes, Hugo M. MBBS, FRANZCOG; Manolitsas, Tom P. MBBS, MRCOG, FRANZCOG, CGO, MD; Jobling, Tom W. MBBS, FRCOG, FRANZCOG, CGO, MD

Journal of Lower Genital Tract Disease: April 2014 - Volume 18 - Issue 2 - p E43–E45
doi: 10.1097/LGT.0b013e3182976219
Case Reports

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.

A review of presentation and management of squamous cell carcinoma of the neovagina in a male-to-female transsexual.

Department of Gynae-Oncology, Monash Medical Centre, Clayton, Victoria, Australia

Reprint requests to: Hugo M. Fernandes, MBBS, FRANZCOG, Department of Gynae-Oncology, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, Australia 3168. E-mail:

The authors have declared they have no conflicts of interest.

Copyright © 2014 by the American Society for Colposcopy and Cervical Pathology