Primary vaginal adenocarcinoma of intestinal type arising from a tubulovillous adenoma.

Enteric or intestinal-type neoplasms of the vagina are extremely rare. The present report describes a 55-year-old woman who presented with a 6-week history of postmenopausal bleeding. On clinical examination, a lesion on the posterior vaginal wall was noticed. Rectovaginal examination suggested a tumor in the rectovaginal septum. Biopsy revealed an adenocarcinoma of the intestinal type, with a small remnant of a villous adenoma. The histologic interpretation pointed in the direction of a metastatic gastrointestinal tumor; yet, clinical examination, rectoscopy, colonoscopy, magnetic resonance imaging (MRI) of the abdomen, and positron emission tomography (PET) scanning excluded this possibility. This led to the conclusion that the lesion was a primary intestinal-type adenocarcinoma of the vagina that had arisen from a vaginal villous adenoma. It is important to be aware of this tumor type and to distinguish them from metastatic colorectal adenocarcinoma in order to plan appropriate treatment.