429 Vaginal cancer with uterine prolapse: a rare entity

Objectives Primary vaginal cancer is a rare condition, constituting 1–2% of all gynecologic malignancies. It usually occurs in patients over 60 years of age. Primary vaginal cancer combined with uterine prolapse is very rare. Methods We present 3 cases of primary vaginal cancer in women with uterine prolapse treated in Salah Azaiez institute between 1997 and 2017 Results The mean age was 74.6 year, the mean parity was 6 parity per woman. Symptoms were blood stained discharge, foul odor leukorrhea, and severe pelvic pain for the last 1 to 3 months. The mean tumor size was 6.3 cm and the tumor location was on the anterior wall in 2 cases and the posterior wall in one case. The prolapse was reduced under intravenous sedation in operating room. On gynecologic examination, uterus was normal in size, no adnexal mass was examined, one patient presented with vesico-vaginal fistulea. Biopsy of the ulcer at vaginal wall revealed invasive squamous cell carcinoma of vagina. The extention work up didn’t reveal any metastasis in none of patients. The tumor was staged at stage I of FIGO in 2 patients and at stage IVA of FIGO in one patient. All the patients underwent surgery, and one patient had adjuvant radiotherapy. The mean follow up was 37.3 months and the patients were free of disease during follow up period. Conclusions Uterine prolapse combined with vaginal cancer is a very uncommon condition. Our series seems to be important due to number of cases reported and the successful treatment management.