A rare case Of gastric cancer: Isolated vaginal metastasis

Abstract Although the frequency of gastric cancer and gastric cancer-related deaths have decreased in recent years, due to the high number of malignant proximal gastric lesions, it is still one of the most leading causes of cancer-related deaths (1) and remains a major health problem worldwide. It is the fourth most common cancer in the world and second most common cause of cancer deaths after lung cancer (2). Ovarian metastasis of gastric cancer is called a Krukenberg tumor. Krukenberg tumors make up 1%-2% of all ovarian cancers (3). The most common source of these tumors is gastric (70%). Following gastric cancer; colon, appendix, and breast cancer, respectively, are the most common causes. Gastric cancer occurs at all ages but most commonly it occurs at around about 45 years of age (4). Distant metastasis of gastric cancer to the vagina has not been reported. Metastatic involvement of vagina is most likely an extension of ovarian or uterine metastasis. Isolated vaginal involvement of gastric cancer has not yet been reported (5). In the present case report, the patient was operated on after neoadjuvant chemotherapy. The patient was followed up every 3 months for one-and-a-half year after the operation. The patient had a history of vaginal bleeding for several months. A mass lesion, 2-3 cm in diameter was detected on the side of the vaginal wall at gynecological examination. A punch biopsy was taken. Pathological examination of the vaginal mass was reported as adenocarcinoma and, it was interpreted as a metastatic lesion from the gastrointestinal tract. The present case is important because it is the first case in literature to report primary vaginal metastasis in the absence of ovarian or uterine metastasis.