HPV-related squamous cell carcinoma in a neovagina after male-to-female gender confirmation surgery

Jesús Bollo, Andrea Balla, Carlos Rodriguez Luppi, Carmen Martinez, Silvia Quaresima, Eduard M. Targarona

Research output: Contribution to journalArticleResearchpeer-review

11 Citations (Scopus)

Abstract

© 2017, © The Author(s) 2017. Vaginoplasty by penile and scrotal skin inversion is a well-established technique for male-to-female gender confirmation surgery. In this setting, chronic inflammation and lacerations associated with history of human papillomavirus (HPV) infection may induce a high risk of malignant degeneration in the long term. A 78-year-old transgender woman was admitted with genital discomfort and neovaginal discharge. The patient’s history revealed male-to-female gender confirmation surgery with construction of a neovagina by penile and scrotal skin inversion at 33 years of age. Physical examination of the genitalia revealed presence of fecal material, suggestive of recto-neovaginal fistula. A biopsy specimen was positive for well-differentiated HPV-related squamous cell carcinoma. Magnetic resonance imaging (MRI) showed a bulky mass in the posterior wall of the neovagina that infiltrated the urethra, prostatic gland and the anterior rectal wall. Following a multidisciplinary evaluation, we performed a definitive sigmoid colostomy and administered chemotherapy. Long-term follow-up seems advisable in patients after vaginoplasty due to the possibility of delayed development of cancer. Following biopsy, we consider MRI as the modality of choice to identify possible infiltration of the adjacent structures. As data regarding these lesions are scarce and management is complex, a multidisciplinary approach is recommended.
Original languageEnglish
Pages (from-to)306-308
JournalInternational Journal of STD and AIDS
Volume29
Issue number3
DOIs
Publication statusPublished - 1 Mar 2018

Keywords

  • Neovagina
  • human papillomavirus, HPV
  • male-to-female gender confirmation surgery
  • penile and scrotal skin inversion
  • squamous cell carcinoma

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