A Case of Primary Endometrioid Adenocarcinoma of the Vagina / 대한산부인과학회지

Primary cancer of the vagina is very rare, accounting for 1-2% of gynecologic malignancies. Vaginal cancers are composed of primary and metastatic one. Of them, metastatic cancers constitute the majority of vaginal cancers, as 80-90%. Differentiating as type of cancer cell, the squamous cell carcinoma is the most common, as 80-90%, but, the adenocarcinoma is rare, as 9% of primary vaginal cancer. Same as other disease, if there is a symptom, the 5 year-survival rate of the vaginal cancer is 37%, but, if not in early stage, that becomes higher, as 61%. So, the early diagnosis and treatment are very important for patients' prognosis. A woman who had underwent both ovarian cystectomy due to both ovarian endometriomas 2 years ago visit us complaining of vaginal spotting, mild lower abdominal discomfort and pelvic pain for 2 months. She underwent operation at the impression of primary vaginal cancer and was irradiated. We report a case of primary endometrioid adenocarcinoma of the vagina with review of literatures.

Transverse Vaginal Septum: Difficult Management Concerning Postoperative Stricture: Report of 2 Cases / 대한산부인과학회잡지

Two cases of incomplete transverse vaginal septum with a small opening in the upper third of vagina were presented. One case was a patient presenting at 31 years of age for evaluation of primary infertility and oligomenorrhea. Diagnosis was made by hysterosalpingography, tranvaginal ultrasonography, MRI, and diagnostic pelviscopy for evaluation of abnormality of endopelvic organs. The patient was treated with surgical resection of septum (simple septectomy). Examination 3 months later demonstrated narrowing of the vaginal lumen. Another case was a patient presenting intrauterine pregnancy at 8 weeks and 2 days accompanying transverse vaginal septum with small opening. She had previous septotomy history and presented postoperative scarring. She had septectomy and anastomosis of the mucosa, and presented postoperative narrowing again about a month postoperatively. In this report we describe the two cases of transverse vaginal septum. We also reviewed the literature including diagnostic and treatment guidelines. Prevention of postoperative scarring is the most important factor in management of transverse vaginal septum. For that, first of all, initial septectomy should be done with approximation of the mucosa and postoperative dilatation is necessary. Importance of the initial accurate septectomy is too important to be over-emphasized.