Vaginal carcinoma in a female-to-male transsexual.

Abstract

INTRODUCTION:

Sex reassignment surgery (SRS) can be considered a reasonable and secure treatment for transsexualism, today. Because the population of patients who have received SRS is growing steadily, it can be expected that the number of patients who present with diseases specific to their original gender will increase as well.

AIM:

In female-to-male transsexuals, vaginal cancer has not been reported so far. This article reports, to our knowledge, the first case of a female-to-male transsexual who developed vaginal cancer.

METHODS:

Eighteen years after receiving female-to-male SRS, the patient presented with vaginal cancer, which infiltrated rectum and bladder and also showed involvement of inguinal lymph nodes. Surgery consisted of an anterior and posterior pelvic demolition and extended lymphadenectomy with preservation of the penoid and reconstruction of the pelvic defect with multiple flaps.

RESULTS:

The tumor was removed completely (R0), and 2 years after surgery, the patient has no signs or symptoms of tumor recurrence and enjoys good quality of life.

CONCLUSIONS:

In SRS patients, diseases of their original gender should always be considered and patients should be encouraged to participate in screening programs. When choosing the surgical approach for SRS, the risks for developing cancer from remaining structures of the genetic gender should be considered. Of course, removal of e.g., ovaries, cervix and vagina, will prevent cancer of these structures. When it comes to surgery in SRS patients with malignancies, an interdisciplinary approach should be chosen.

• Authors: Thilo Ludwig Schenck, Thomas Holzbach, Niko Zantl, Christopher Schuhmacher, Markus Vogel, Stefan Seidl, Hans-Gunther Machens, Riccardo Enzo Giunta
• Journal: The journal of sexual medicine (J Sex Med) Vol. 7 Issue 8 Pg. 2899-902 (Aug 2010) ISSN: 1743-6109 [Electronic] Netherlands
• PMID: 20102482 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2010 International Society for Sexual Medicine.

Topics

• Adult
• Carcinoma, Squamous Cell (diagnosis, pathology, surgery)
• Cooperative Behavior
• Female
• Follow-Up Studies
• Human papillomavirus 16
• Humans
• Interdisciplinary Communication
• Lymph Node Excision
• Lymphatic Metastasis
• Magnetic Resonance Imaging
• Microsurgery (methods)
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Staging
• Papillomavirus Infections (diagnosis, pathology, surgery)
• Pelvic Exenteration
• Postoperative Complications (diagnosis, pathology, surgery)
• Prostheses and Implants
• Rectum (pathology)
• Sex Reassignment Surgery
• Surgical Flaps (blood supply)
• Surgical Mesh
• Transsexualism (surgery)
• Urinary Bladder (pathology)
• Vaginal Neoplasms (diagnosis, pathology, surgery)