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Your search keyword '"Mhawech-Fauceglia, Paulette"' showing total 13 results
Start Over Author "Mhawech-Fauceglia, Paulette" Journal international journal of gynecological pathology
13 results on '"Mhawech-Fauceglia, Paulette"'

13. Primary Vaginal Adenocarcinoma Arising in Vaginal Adenosis After CO2Laser Vaporization and 5-Fluorouracil Therapy

Author

Paczos, Tamera A., Ackers, Stacey, Odunsi, Kunle, Lele, Shashikant, and Mhawech-Fauceglia, Paulette

Abstract

We present a case of a 45-year-old woman with a long-standing history of persistent cervical dysplasia that resulted in a hysterectomy. Subsequent vaginal smears revealed high-grade vaginal intraepithelial neoplasia (VAIN III) on Pap smear with positive human papilloma virus (HPV) testing. Over the course of 2 years, the patient underwent 2 CO2laser vaporization procedures of the upper vagina and intermittent 5-fluorouracil therapy. A biopsy performed at the time of the second laser procedure revealed endocervical-type well-differentiated adenocarcinoma, associated with VAIN III. HPV in situhybridization for HPV types 16 and 18 was positive in both the glandular and squamous mucosa. The patient has no known history of intrauterine diethylstilbestrol exposure or mullerian developmental abnormalities. Subsequently, the patient underwent a radical upper vaginetcomy with bilateral pelvic lymph nodes dissection and bilateral salpingo-oophorectomy. The vaginectomy specimen showed residual adenocarcinoma associated with VAIN-III and extensive vaginal adenosis with free resection margins. This is the second reported case in the literature of adenocarcinoma arising in vaginal adenosis after 5-fluorouracil. Herein, we highlight these important findings and shed some light on the pathogenesis of vaginal adenosis and the subsequent development of vaginal adenocarcinoma.

Published
2010
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