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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: hugo@melbwh.com.au

The authors have declared they have no conflicts of interest.

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