Neovaginal cancer after sigmoid vaginoplasty: Implications for postoperative cancer surveillance
Wouter B. van der Sluis,
Nanne K.H. de Boer,
Marlon E. Buncamper,
Adriaan A. van Bodegraven,
Jurriaan B. Tuynman,
Mark-Bram Bouman
Affiliations
Wouter B. van der Sluis
Dept. of Plastic and Reconstructive Surgery, Amsterdam UMC, Amsterdam, the Netherlands; Center of Expertise on Gender Dysfphoria, Amsterdam UMC, Amsterdam, the Netherlands; Corresponding author at: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Nanne K.H. de Boer
Dept. of Gastroenterology, Amsterdam UMC, Amsterdam, the Netherlands
Marlon E. Buncamper
Dept. of Plastic and Reconstructive Surgery, Amsterdam UMC, Amsterdam, the Netherlands; Center of Expertise on Gender Dysfphoria, Amsterdam UMC, Amsterdam, the Netherlands
Adriaan A. van Bodegraven
Dept. of Gastroenterology, Amsterdam UMC, Amsterdam, the Netherlands; Dept. of Gastroenterology, Zuyderland Medical Center, Sittard-Geleen, the Netherlands
Jurriaan B. Tuynman
Dept. of Surgery, Amsterdam UMC, Amsterdam, the Netherlands
Mark-Bram Bouman
Dept. of Plastic and Reconstructive Surgery, Amsterdam UMC, Amsterdam, the Netherlands; Center of Expertise on Gender Dysfphoria, Amsterdam UMC, Amsterdam, the Netherlands
Background: Intestinal vaginoplasty can be performed as vaginal reconstruction procedure. Aa pedicled intestinal segment is isolated and transferred to the (neo)vaginal cavity to form the neovaginal lining. Case: A 38-year old patient with Fanconi anemia and congenital vaginal absence, who underwent sigmoid vaginoplasty at the age of one, visited the outpatient clinic with a palpable neovaginal mass. At MRI examination, a neovaginal tumor was observed of approximately 25 × 10 mm without lymphadenopathy, which turned out to be a mucinous adenocarcinoma (T3N0M0). She underwent excision of the total mesocolon, including the sigmoid neovagina, coloanal anastomosis and anus. Summary and Conclusion: Postoperative cancer surveillance seems justified after sigmoid vaginoplasty, even more so in patients with a (genetically) high risk of developing cancer and/or with a history of malignancy.
