We report a case of a woman who was suffering from post-
radiochemotherapy perineum
abscess concurrent with the recurrence of
vaginal cancer for which total
pelvic exenteration was performed. A 66-year-oldwoman presentedat our hospital with irregular genital
bleeding in November 2014. A series of examinations showedthat she was suffering from
vaginal cancer(cT2N0M0, cStage II ). A
radiochemotherapy regimen(external irradiation 45 Gy/25 Fr, CDDP 40mg/m2, 5 course)was commencedin January 2015. In the meantime, MRI revealedsome
therapeutic effect, but in October 2015, MRI indicated the enlargement of the primary
tumor(PD). The
chemotherapy regimen was alteredanda regimen of
paclitaxel plus
nedaplatin was commenced in November 2015 andw as continueduntil April 2016. MRI was performedin March 2016 to distinguish the therapeutic response between PR and CR. In May 2016, the patient complainedof an increasedfrequency of
melena. Colonoscopy was performedto reveal Grade 3 radiation
enteritis, andargon plasma coagulation was requiredto stop
bleeding. In June 2016, MRI was performedandrevealedCR. In July 2016, however, the radiation
enteritis led to
rectovaginal fistula, for which we performed transverse
colostomy. Thereafter, the necrotic tissue gradually expanded into the perineum area to involve the urethra. Recurrence of the
cancer was suspected; therefore, we decided to perform total
pelvic exenteration in December 2016. Pathological examination of the surgical specimen indicated the recurrence of the
vaginal cancer. We report this rare case andd iscuss the usefulness of total
pelvic exenteration for the recurrence of
vaginal cancer.