Vaginal cancer as a late complication of radiotherapy for endometrial cancer and ileo-perineal fistula after total pelvic exenteration

Pelvic exenteration is a highly morbid operation and remains one of the most catastrophic surgical procedures in gynecological oncology. We would like to present the case of total pelvic exenteration for vaginal cancer after radiotherapy for endometrial cancer as a secondary cancer. A 62-year-old woman, whose gravida: 3, parity: 2, body mass index: 35.9 kg/m(2), presented with complaints of vaginal bleeding. She had undergone a surgery because of a stage IB grade 2 endometrioid-type adenocarcinoma seventeen years previously. Following the surgery, she had external pelvic radiotherapy and brachytherapy. A palpable, solid and ulcerative mass was detected extending from the vaginal cuff area to the vestibulum vagina on the left postero-lateral wall of the vagina. The 5-cm vaginal mass was seen at vaginal examination. A punch biopsy from a pathological examination of the tumoral lesion was reported as a squamous cell carcinoma. Pelvic exenteration was performed and ileo-perineal fistula occurred after six months this surgery. In conclusion, we considered that this malignancy was a secondary malignancy induced by radiotherapy.