title: Gynecologic bleeding revealing vaginal metastasis of renal cell carcinoma.
abstract: Vaginal metastases of renal cell carcinoma have been rarely described. We report a case of a 75-year old woman, who underwent radical right nephrectomy for a renal cell carcinoma. Tumour was classified pT3bN0M0 and grade III of Furhmann grading. One year later, scanner discovered mediastinal and lombo-aortic lymph nodes. She received 2 months of immunotherapy associated with bevacizumab, but stopped because of intolerance. She was readmitted in our institute for vaginal bleeding. Clinical investigations showed a vaginal mass and biopsy revealed a renal cell carcinoma metastasis. This case suggests that retrograde venous dissemination may be at the origin of vaginal metastasis of renal cell carcinoma and emphasized the preventive value of early ligature of renal vein.
authors.affiliation: Department of medecine, Gustave Roussy Institute, France.
authors.forename: Zineb
authors.initials: Z
authors.lastname: Benbrahim
authors.forename: Ali
authors.initials: A
authors.lastname: Chouaib
authors.forename: Renaud
authors.initials: R
authors.lastname: Mazeron
authors.forename: Marie Bénédicte
authors.initials: MB
authors.lastname: Leger-Ravet
authors.forename: Catherine
authors.initials: C
authors.lastname: Lefort
authors.forename: Catherine
authors.initials: C
authors.lastname: Lhommé
authors.forename: Omar
authors.initials: O
authors.lastname: El Mesbahi
authors.forename: Bernard
authors.initials: B
authors.lastname: Escudier
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000532:radiotherapy; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy; D012082:Renal Veins; D014625:Vaginal Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*
keywords: Gynecologic bleeding; carcinoma; metastasis; vagina
references.citation: Gynecol Oncol. 2004 Mar;92(3):970-3
references.pmid: 14984968
references.citation: Prog Urol. 1994 Feb;4(1):95-7
references.pmid: 7514474
references.citation: Eur J Gynaecol Oncol. 1998;19(1):14-8
references.pmid: 9476051
references.citation: Urology. 2006 Apr;67(4):847.e1-2
references.pmid: 16600343
references.citation: J Urol. 1970 Jul;104(1):50-2
references.pmid: 5426709
references.citation: Actas Urol Esp. 2008 Jun;32(6):653-5
references.pmid: 18655352