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Aim: Primary vaginal cancer is rare, comprising about 3% of all gynaecological malignancies. Solitary bone metastases to appendicular skeleton are extremely rare and there are only few published reports. We report the case of isolated metastasis in the tibia as a feature of primary squamous vaginal carcinoma. We present this case because of its rarity and for documentation and discussion purposes. Case report: We present a case of a 44-year old woman diagnosed with squamos vaginal cancer in June 2015. Computed tomography of the thorax, abdomen and pelvis revealed no distant metastases. She was treated with interstitial intracavitary brachytherapy and concomitant chemoradiotherapy. In March 2016 she was admitted to our hospital because of the swelling and the pain in the lower right leg. There was no history of trauma and plain radiographs were normal. Two months later, after further progression of pain, plain radiographs showed intramedullary permeative bone lesion with cortical disruption of tibial dyaphisis and local soft tissue swelling. MRI and core needle biopsy confirmed vaginal cancer metastasis containing tumor cells identical to the primary tumor. The patient was treated with radiotherapy and chemotherapy. Despite the treatment there was further progression of the disease with multiple bone metastases and eventually lung and brain metastases. Conclusion: This case report is another reminder that although extremely rare, solitary metastatic bone lesions of vaginal cancer are possible. Since symptoms mimic various benign conditions, it is important to consider bone metastasis as possible diagnosis in patients with progressive bone pain not responding to analgesic treatment. [ABSTRACT FROM AUTHOR]

CT urography (CTU) is an imaging method tailored specifically for the evaluation of the upper urothelial tract and urinary bladder. High diagnostic accuracy in detecting primary and recurrent urothelial tumours, their differentiation from benign lesions, anatomic variation and malformation characterization, and evaluation of important pathology in the surrounding tissues, renders CTU a valuable imaging study of the urothelial tract. Haematuria, initial staging and post treatment follow up of upper urinary tract and bladder malignancies are the most important indications for CTU. Triple phase and split bolus techniques are most commonly used CTU protocols that consist of a non-contrast, nephrographic, and excretory phase, obtained by three or two acquisitions. CTU scanning protocols are tailored to achieve adequate image quality with optimal opacification and distension of the urinary tract at the lowest achievable radiation dose within the range of 5-15 mSv, comparable to the doses of intravenous urography. Detailed patient history, clinical examination, and urine analysis are essential for proper patient selection and targeted CTU protocol, which are the most important tools for increasing diagnostic accuracy and lowering patient radiation dose of CT urography. [ABSTRACT FROM AUTHOR]