DOI: 10.36347/sjmcr.2021.v09i04.024

Pages: 393-397

Very few cases of Primary Vaginal Clear cell Adenocarcinoma (PVCAA) have been reported in literature. A multiparous lady aged 52 years presented with bleeding per vaginum for 1 week. On examination 3x3 cm ulceroproliferative growth involving lower third with subvaginal extension seen. On colposcopy cervix was normal. The uterus and ovaries were normal on imaging. Biopsy from the mass revealed Clear Cell carcinoma. She underwent radical vaginectomy, distal urethral resection(approx 3cm), bilateral groin node dissection and lotus flap reconstruction of defect. Histopathology showed Clear Cell Carcinoma of vagina, Stage III. Adjuvant chemotherapy with cisplatin and paclitaxel 3 weekly for 6 cycles was followed by adjuvant External Beam Radiotherapy. Patient had presented with occasional involuntary dribbling of urine following the surgery which was managed with foleys catheterisation. The incontinence resolved without any intervention one month following radiotherapy. The patient has been recurrence free for past 3 years. The tumour board faced difficulty in taking decisions due to dearth of reported cases and consensus guidelines, prompting the authors to report the case.