Squamous cell carcinoma of the vagina in pregnancy is rare.
A 28-year-old primigravida with antepartum bleeding at 20 weeks' gestation was diagnosed with squamous cell carcinoma after biopsy of a vaginal mass. The histology revealed an invasive grade 3 squamous cell carcinoma of large-cell, nonkeratinizing type. The patient declined pregnancy termination and immediate radiation treatment. She continued to have episodes of vaginal bleeding and was admitted at 30 weeks' gestation. A decision was made in consultation with the neonatal unit to deliver her at 32 weeks' gestation. After corticosteroid treatment, she was delivered by cesarean delivery. Positive pelvic lymph nodes were noted at surgery. Postoperatively, she received external beam radiation and brachytherapy and concurrent cisplatin chemotherapy. She is disease free 3 years from her original diagnosis.
This case emphasizes the importance of a thorough pelvic examination to assess the vaginal walls and cervix at the first prenatal visit and with any antepartum bleeding episode.
Management of a young woman who presented at 20 weeks' gestation with a vaginal squamous cell carcinoma is described.
Department of Obstetrics and Gynecology, Radiation Oncology, and Pathology, University of Alberta, Edmonton, Alberta, Canada
Address reprint requests to: H. L. Steed, MD, Department of Obstetrics and Gynecology, CSC-201, Royal Alexandra Hospital Site, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada; E-mail: email@example.com.
The authors acknowledge the assistance of Chris Hoskins, MD.
Received December 4, 2001. Received in revised form March 15, 2002. Accepted April 4, 2002.