Journal List > J Lung Cancer > v.8(2) > 1050700

J Lung Cancer. 2009 Dec;8(2):111-113. Korean.
Published online December 31, 2009.  https://doi.org/10.6058/jlc.2009.8.2.111
©2009 Korean Association for the Study of Lung Cancer
Primary Lung Adenocarcinoma Metastasis to the Vagina: A Case Report
Seung Yeon Ha, M.D.,1 Sanghui Park, M.D.,1 Eun Kyung Cho, M.D.,2 Soyi Lim, M.D.,3 and Jung Suk An, M.D.4
1Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea.
2Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
3Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.
4Department of Pathology, Sungkyunkwan University Samsung Medical Center, Seoul, Korea.

Address for correspondence: Seung Yeon Ha, M.D. Department of Pathology, Gachon University Gil Hospital, 1198, Guwol 1-dong, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-3078, 3073, Fax: 82-32-460-3073, Email: syha@gilhospital.com
Received July 24, 2009; Revised August 31, 2009; Accepted September 03, 2009.

Abstract

Lung cancer is a malignant tumor that is often fatal. Vaginal metastasis of pulmonary adenocarcinoma is very rare. To the best of our knowledge, this is the second such report worldwide and the first one from Korea. A 67-year-old woman presented with cough, excessive sputum and dyspnea that she had sufferd with for the past one year and she had a palpable lesion in the vagina. Chest CT showed diffuse bronchial wall thickening involving the left main bronchus, the left upper lobar bronchus and the lingular divisional bronchus of the left upper lobe. There were multiple, various sized nodules in both lungs, of which the largest one measured about 1.0 cm in diameter. Both lung and vaginal biopsies were performed and the masses were diagnosed as adenocarcinoma. Immunohistochemically, the tumor cells were positive for cytokeratin 7 and TTF-1, but they were negative for cytokeratin 20. We present this case of primary lung adenocarcinoma metastasis to the vagina.

Keywords: Carcinoma; Lung; Vagina; Metastasis

Figures


Fig. 1
Chest CT showed the bronchial wall thickening involving the left main bronchus and the left upper lobar bronchus (arrow).
Click for larger image


Fig. 2
The histological findings for the lung mass: bronchoscopic biopsy showed infiltration of atypical ovoid cells with round nuclei and plump cytoplasm (inlet) (A, H&E stain, ×40). The tumor cells were positive for TTF-1 (B, TTF-1, ×200). The histological findings for the tumor cells in the vagina: microscopically, the same atypical cells of the lung (inlet) tumor had infiltrated into the vaginal stroma (C, H&E stain, ×40). These cells revealed a positive reaction for TTF-1 (D, TTF-1, ×200).
Click for larger image

References
1. Rosen ST, Aisner J, Makuch RW, et al. Carcinomatous leptomeningitis in small cell lung cancer: a clinicopathologic review of the National Cancer Institute experience. Medicine (Baltimore) 1982;61:45–53.
2. National Cancer Information Center. Goyang (Korea): National Cancer Information Center; [2008 Nov 13]. NCIC Cancer Information Service [Internet].
3. Kumar V, Abbas AK, Fausto N, Robbins SL, Cotran RS. In: Robbins and Cotran pathologic basis of disease. 7th ed. Philadelphia: Elsevier Saunders; 2005.
4. Jahnke A, Domke R, Makovitzky J, Nizze H, Briese V. Vaginal metastasis of lung cancer: a case report. Anticancer Res 2005;25:1645–1648.
5. Mazur MT, Hsueh S, Gersell DJ. Metastases to the female genital tract. Analysis of 325 cases. Cancer 1984;53:1978–1984.
6. Fader AN, Brainard JA, Rose PG. Symptomatic vaginal bleeding in a postmenopausal woman: a case report of pancreatic adenocarcinoma metastasizing exclusively to the vagina. Am J Obstet Gynecol 2007;197:e8–e9.
7. Saad RS, Liu YL, Han H, Landreneau RJ, Silverman JF. Prognostic significance of thyroid transcription factor-1 expression in both early-stage conventional adenocarcinoma and bronchioloalveolar carcinoma of the lung. Hum Pathol 2004;35:3–7.
8. Geldof AA. Models for cancer skeletal metastasis: a reappraisal of Batson's plexus. Anticancer Res 1997;17:1535–1539.