title: Mesonephric adenocarcinoma of the vagina : Diagnosis and multimodal treatment of a rare tumor and analysis of worldwide experience.
abstract: BACKGROUND
  Mesonephric adenocarcinoma of the vagina is an extremely rare tumor of the female genital tract, with only a few cases reported so far worldwide. Consequently, there is no established standard treatment and limited knowledge about the prognosis and biologic behavior of vaginal mesonephric adenocarcinoma.
  
  
  METHODS
  This report documents a new case of vaginal mesonephric adenocarcinoma diagnosed in a 54-year-old woman, and analyzes this in the context of all previously published cases.
  
  
  RESULTS
  MRI demonstrated that the 2.5 × 1.8 cm tumor of the vaginal wall was invading urethra and bladder. Following surgical excision, histologic analysis determined mesonephric adenocarcinoma of the vagina, stage pT2 R1. In order to avoid the mutilating extended surgery which would be required to reach R0 and considerable impairment of quality of life, adjuvant radiochemotherapy was administered with external radiation and brachytherapy, including 5 cycles of cisplatin (40 mg/m²) for radiosensitization. After 4 years of continuous oncologic follow-up, the patient is alive and clinically free of disease.
  
  
  CONCLUSIONS
  In this case it was shown that adjuvant radiochemotherapy with radiation and brachytherapy was effective to manage the surgical R1 situation and maintain the patient's life quality. More published cases reports are needed to gradually substantiate optimal treatment strategies.
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria. i.haberlehner@salk.at.
authors.forename: Iris
authors.initials: I
authors.lastname: Mueller
authors.affiliation: Department of Radiology and Radiation Oncology, Paracelsus Medical University (PMU), Müllner Hauptstrasse 48, 5020 Salzburg, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kametriser
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.
authors.forename: Volker R
authors.initials: VR
authors.lastname: Jacobs
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bogner
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.
authors.forename: Alfons
authors.initials: A
authors.lastname: Staudach
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.
authors.forename: Horst
authors.initials: H
authors.lastname: Koch
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.
authors.forename: Pia
authors.initials: P
authors.lastname: Wolfrum-Ristau
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.
authors.forename: Christiane
authors.initials: C
authors.lastname: Schausberger
authors.affiliation: Department of Obstetrics and Gynecology (OB/GYN), Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Fischer
authors.affiliation: Department of Radiology and Radiation Oncology, Paracelsus Medical University (PMU), Müllner Hauptstrasse 48, 5020 Salzburg, Austria.
authors.forename: Felix
authors.initials: F
authors.lastname: Sedlmayer
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D059248:Chemoradiotherapy / Q000379:methods*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D020266:Radiotherapy, Conformal / Q000379:methods*; D035583:Rare Diseases / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000473:pathology* / Q000628:therapy*; D014928:Wolffian Ducts / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects
keywords: Brachytherapy; Diethylstilbestrol; Quality of life; Radiochemotherapy; Radiotherapy