Vaginal metastasis and thrombocytopenia from renal cell carcinoma.
BACKGROUND
Vaginal cancer represents approximately 1-2% of genital tract malignancies. Most cases represent metastasis from the cervix, endometrium, or colon. Metastasis of renal cell carcinoma to the vagina is extremely rare.


METHODS
A 58-year-old female presented with a bleeding vaginal lesion. Laboratory studies revealed severe thrombocytopenia, and radiological studies revealed a left renal mass; excision was consistent with metastatic renal cell carcinoma. A subsequent nephrectomy confirmed renal cell carcinoma. Postoperatively, the patient underwent immunotherapy and the thrombocytopenia resolved.


CONCLUSIONS
We report the first case of metastatic renal cell carcinoma presenting as a vaginal metastasis with thrombocytopenia as a paraneoplastic manifestation. Renal cell carcinoma must be in the differential diagnosis of a clear cell neoplasm in a postmenopausal woman, particularly with systemic symptoms suggestive of a paraneoplastic syndrome.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Walter Reed Army Medical Center and the National Naval Medical Center, Washington, DC, USA.
Jay E
JE
Allard
John W
JW
McBroom
Christopher M
CM
Zahn
David
D
McLeod
G Larry
GL
Maxwell
D002292:Carcinoma, Renal Cell / Q000097:blood / Q000150:complications / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D013921:Thrombocytopenia / Q000209:etiology*; D014625:Vaginal Neoplasms / Q000150:complications / Q000556:secondary*