Synchronous Vaginal and Liver Metastases in Rectosigmoid Cancer: Case Report and Literature Review.

Vaginal metastasis from colorectal cancer is extremely rare. We report the case of a 58-year-old postmenopausal woman with rectosigmoid adenocarcinoma and synchronous liver and vaginal metastases who initially presented with gastrointestinal symptoms followed by vaginal bleeding. The diagnosis was established through colonoscopy, biopsy, CT, MRI, and FDG PET-CT. After 6 cycles of FOLFOX chemotherapy, the liver metastases regressed, while the primary tumor and vaginal lesions progressed. She subsequently underwent pelvic exenteration with ileal conduit formation and right hepatectomy, followed by pulmonary metastasectomy and stereotactic body radiotherapy for subsequent lung metastases. At 41 months of follow-up from diagnosis, the patient remains alive with disease and has demonstrated a favorable response to multimodal therapy. This case highlights the importance of gynecological evaluation in female patients with colorectal cancer and demonstrates that aggressive multimodal management can achieve prolonged disease control.