Unusually aggressive primary cloacogenic carcinoma of the vulva: A case report and literature review

Rajni Chibbar, Kimberly A. Wood, Christopher K. Giede, Anita Agrawal

College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Department of Obstetrics and Gynecology, Royal University Hospital, Saskatoon, Canada.
Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Canada;.
Department of Pathology, University of Saskatchewan, Saskatoon, Canada.

DOI: 10.4236/crcm.2013.25081                

Abstract

Vulvar cancer is an uncommon tumor and represents 3%-5% of all female genital tract malignancies. The overall incidence is 1.5/100,000 women. Histopathologically the vast majority (90%) are squamous cell carcinomas. Primary cloacogenic carcinoma of the vulva is extremely rare with less than 20 cases reported in English literature [1]. These tumors are thought to arise from embryonic or ectopic rests of cloacogenic tissue. The majority of these reported cases is relatively indolent cancer, only one case of cloacogenic carcinoma of the vulva reported metastatic spread to the inguinal lymph nodes and none that describe distant metastases. Here we present an aggressive and diagnostically challenging case of cloacogenic carcinoma of the vulva and a review of current literature to date.

Keywords

Cloacogenic Vulvar Cancer; Metastasis

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Lui, S.H., Ho, C.M., Huang, S.H., et al. (2003) Cloacogenic adenocarcinoma of the vulva presenting as recurrent Bartholin’s gland infection. Journal of the Formosan Medical Association, 102, 49-51.
[2]	Titlman, A.J. and Knutzen, V.K. (1978) Primary adenocarcinoma of the vulva originating in misplaced cloacal tissue. Obstetrics & Gynecology, 51, 30s-33s.
[3]	Dube, V., Veilleux, C., Plante, M., et al. (2004) Primary villoglandular adenocarcinoma of cloacogenic origin of the vulva. Human Pathology, 35, 377-379. doi:10.1016/j.humpath.2003.05.002
[4]	Kennedy, J.C. and Majmudar, B. (1993) Primary adenocarcinoma of the vulva, possibly cloacogenic: A report of two cases. Journal of Reproductive Medicine, 38, 113-116.
[5]	Ghamande, S.A., Kasznica, J., Griffiths, C.T., et al. (1995) Mucinous adenocarcinomas of vulva. Gynecologic Oncology, 57, 117-120. doi:10.1006/gyno.1995.1108
[6]	Willen, R., Békássy, Z., Carlén, B., et al. (1999) Cloacogenic adenocarcinoma of the vulva. Gynecologic Oncology, 74, 298-301. doi:10.1006/gyno.1999.5433
[7]	Fox, H., Wells, M., Harris, M., et al. (1988) Enteric tumours of the lower female genital tract: A report of three cases. Histopathology, 12, 167-176. doi:10.1111/j.1365-2559.1988.tb01927.x
[8]	Zaida, S.N.H. and Conner, M.G. (2001) Primary vulvar adenocarcinoma of cloacogenic origin. Southern Medical Journal, 94, 744-746. doi:10.1097/00007611-200107000-00025
[9]	Larson, W.J. (1997) Development of the urogenital system. In: Human Embryology, 2nd Edition, Churchill Livingstone Inc., New York, 261-310.
[10]	Sink, J.D., Kramer, S.A., Copeland, D.D., et al. (1978) Cloacogenic carcinoma. Annals of Surgery, 188, 53-59. doi:10.1097/00000658-197807000-00009
[11]	Lee, K.C., Su, W.P. and Muller, S.A., (1990) Multicentric cloacogenic carcinoma: Report of a case with anogenital pruritus at presentation. Journal of American Academy of Dermatology, 23, 1005-1008. doi:10.1016/0190-9622(90)70323-A