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Las neoplasias ginecológicas en niñas son raras. Representan menos del 5 % de todos los cánceres en pediatría. No existen estadísticas sobre la incidencia de tumores de vagina en esta etapa de la vida. Se presenta el caso de una niña de 9 meses con sangrado por genitales. La ecografía evidencia una masa sólida en vagina, y la vaginoscopia, un tumor friable. Presenta valores de α-fetoproteína elevados, por lo que se diagnostica tumor de saco vitelino, confirmado por biopsia. Se realiza tratamiento quimioterápico. A menos de 1 año del diagnóstico, se encuentra en remisión completa. Este caso resulta de interés no solo por la rareza, sino también porque el diagnóstico rápido de tumor de saco vitelino permite mejorar los resultados y la sobrevida de las pacientes

Gynecological neoplasms in girls are rare and represent only less than 5 % of all childhood tumors. There are no statistics on the incidence of vaginal tumors at this stage in life. We present a 9-month-old girl evaluated for genital bleeding. Ultrasound reveals a vaginal solid mass and vaginoscopy reports a friable tumor. AFP is elevated. A yolk sac tumor is confirmed by biopsy she receives chemotherapy. Within a year after diagnosis, she remains tumor-free. This is a case of interest, not only because of its rarity, but also because a rapid diagnosis of a yolk sac tumor improves outcomes and patient's survival rates.

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Gynecological neoplasms in girls are rare and represent only less than 5 % of all childhood tumors. There are no statistics on the incidence of vaginal tumors at this stage in life. We present a 9-month-old girl evaluated for genital bleeding. Ultrasound reveals a vaginal solid mass and vaginoscopy reports a friable tumor. AFP is elevated. A yolk sac tumor is confirmed by biopsy she receives chemotherapy. Within a year after diagnosis, she remains tumor-free. This is a case of interest, not only because of its rarity, but also because a rapid diagnosis of a yolk sac tumor improves outcomes and patient's survival rates.

Las neoplasias ginecológicas en niñas son raras. Representan menos del 5 % de todos los cánceres en pediatría. No existen estadísticas sobre la incidencia de tumores de vagina en esta etapa de la vida. Se presenta el caso de una niña de 9 meses con sangrado por genitales. La ecografía evidencia una masa sólida en vagina, y la vaginoscopia, un tumor friable. Presenta valores de α-fetoproteína elevados, por lo que se diagnostica tumor de saco vitelino, confirmado por biopsia. Se realiza tratamiento quimioterápico. A menos de 1 año del diagnóstico, se encuentra en remisión completa. Este caso resulta de interés no solo por la rareza, sino también porque el diagnóstico rápido de tumor de saco vitelino permite mejorar los resultados y la sobrevida de las pacientes.

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Resumen ANTECEDENTES: Los leiomiomas son los tumores pélvicos más frecuentes en la mujer; sin embargo, su localización vaginal es excepcional. Suelen ser asintomáticos y encontrarse como un hallazgo clínico. En los últimos 20 años solo se han reportado 85 casos, y solo dos han sido recurrentes. OBJETIVO: Reportar un caso de miomatosis vaginal recurrente en una paciente histerectomizada y revisar la bibliografía al respecto. CASO CLÍNICO: Paciente de 58 años, histerectomizada, con una tumoración vaginal. El reporte histopatológico informó una proliferación fusocelular, debidamente delimitada, dispuesta en haces entrecruzados. Los núcleos eran alargados, monomorfos y de extremos romos. El estroma era escaso y colagénico. No se observaron atipias citonucleares ni necrosis. El estudio inmunohistoquímico de la lesión con actina de anticuerpos antimúsculo liso y desmina se reportó positivo. Se diagnosticó miomatosis vulvovaginal recurrente. Se trató mediante resección quirúrgica. CONCLUSIÓN: Los leiomiomas vulvovaginales son extremadamente raros y la bibliografía al respecto es poca; su recurrencia es verdaderamente excepcional. De ahí la importancia de la publicación de estos casos, que aporta información que pueden tomar en cuenta otros clínicos al momento del diagnóstico.

Abstract BACKGROUND: Leiomyomas are the most frequent pelvic tumors in women; however, their vaginal location is unusual. They are usually asymptomatic and present as a clinical finding. In the last 20 years only 85 cases have been reported, and only two have been recurrent. OBJECTIVE: To report a case of recurrent vaginal myomatosis in a hysterectomized patient and review the literature. CLINICAL CASE: A 58-year-old hysterectomized patient with a vaginal tumor. The histopathologic report reported a fusocellular proliferation, properly delimited, arranged in crisscross bundles. The nuclei were elongated, monomorphous and blunt ended. The stroma was sparse and collagenous. No cytonuclear atypia or necrosis were observed. Immunohistochemical study of the lesion with anti-smooth muscle antibody actin and desmin was reported positive. Recurrent vulvovaginal myomatosis was diagnosed. It was treated by surgical resection. CONCLUSION: Vulvovaginal leiomyomas are extremely rare, and the literature is sparse; their recurrence is truly exceptional. Hence the importance of publishing these cases, providing information to be considered by other clinicians at the time of diagnosis.

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RESUMEN Objetivo: presentar el caso de una paciente con síndrome de Mayer-Rokitansky-Küster-Hauser, con diagnóstico de carcinoma escamoso en neovagina, y realizar una revisión de la literatura del tratamiento y pronóstico de las neoplasias o la infección por VPH de tejidos neovaginales en mujeres transgénero o con síndrome MRKH. Materiales y métodos: mujer de 56 años de edad que consulta en un hospital universitario regional de la ciudad de Sevilla (España). Tras la exploración clínica se aprecia una tumoración exofítica en fondo de vagina, con resultado de biopsia de carcinoma escamoso y cultivo positivo para virus del papilloma humano (VPH) tipo 16. Se realizó una búsqueda bibliográfica en la base de datos Medline vía PubMed, con los términos: "congenital abnormalities"; "mullerian aplasia"; "neovagina"; "vaginal neoplasms"; "squamous carcinoma"; "HPV infection", de reportes y series de caso, y estudios observacionales publicados desde el año 2000 hasta octubre de 2019 en inglés y español. Resultados: se incluyeron 14 estudios; de estos, siete correspondieron a carcinoma escamocelular, tres a adenocarcinoma y cuatro informan infección solo por VPH. Todos los carcinomas escamocelulares presentaban estadios avanzados por compromiso local o linfático y recibieron radioterapia con quimioterapia concomitante o cirugía radical. El pronóstico fue malo en tres de los casos. Las pacientes con adenocarcinoma también presentaron lesiones avanzadas con compromiso local, el tratamiento fue quirúrgico, con quimioterapia concomitante en dos de los casos. Solo una paciente tuvo seguimiento mayor a cinco años. La infección por VPH es frecuente en mujeres sometidas a construcción de neovagina. Conclusiones: las pacientes con neovagina son susceptibles de desarrollar carcinomas escamosos si se utilizaron injertos cutáneos, o adenocarcinomas en aquellas en las que se reconstruyó la vagina a partir de injertos tisulares intestinales. Dado que al momento del diagnóstico presentan compromiso local, a menudo requieren tratamientos radicales o combinados. Se debe investigar cuáles son las mejores estrategias de tamizaje de VPH, cáncer escamoso y adenocarcinoma en este tipo de pacientes.

ABSTRACT Objective: To present the case of a squamous carcinoma in the neovagina of a patient with Mayer-Rokitansky-Küster-Hauser syndrome and review of the literature related to treatment and prognosis of vaginal neoplasms or HPV infection in transgender women or with MRKH syndrome. Materials and methods: A 56-year-old woman consulted to the Hospital Universitario of Sevilla (Spain). During the clinical examination, a exophytic tumor at the bottom of the vagina was found and the biopsy reported squamous carcinoma and positive nucleic acid amplification test for human papilloma (HPV) type 16. A literature search of case reports, case series and observational studies published from 2000 to October 2019 in English and Spanish was performed in Medline via PubMed, with the following terms: "congenital abnormalities"; "Mullerian aplasia"; "neovagina"; "Vaginal neoplasms"; "Squamous carcinoma"; "HPV infection" was performed. Results: 14 studies were finally included; seven corresponded to squamous cell carcinoma, three to adenocarcinoma and four reported HPV infection only. All of the squamous cell carcinomas were at advanced stages due to local or lymphatic compromise and received radiotherapy with concomitant chemotherapy or radical surgery. The prognosis was bad in three of the cases. Patients with adenocarcinoma also presented with advanced lesions due to local extensión and received surgical treatment and two cases received concomitant chemotherapy. Only one patient was followed-up for five years or more. HPV infection is common in women who underwent neovagina reconstruction. Conclusions: Patients with neovagina are susceptible to develope squamous carcinomas or adenocarcinomas depending if skin or intestinal tissue grafts are used. According to local compromise at the time of diagnosis, radical or combined treatments are required. Which screening strategies for HPV, squamous cell carcinomas and adenocarcinoma is to be investigated.

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Objective: To present the case of a squamous carcinoma in the neovagina of a patient with Mayer-Rokitansky-Küster-Hauser syndrome and review of the literature related to treatment and prognosis of vaginal neoplasms or HPV infection in transgender women or with MRKH syndrome. Materials and methods: A 56-year-old woman consulted to the Hospital Universitario of Sevilla (Spain). During the clinical examination, a exophytic tumor at the bottom of the vagina was found and the biopsy reported squamous carcinoma and positive nucleic acid amplification test for human papilloma (HPV) type 16. A literature search of case reports, case series and observational studies published from 2000 to October 2019 in English and Spanish was performed in Medline via PubMed, with the follow- ing terms: "congenital abnormalities"; "Mullerian aplasia"; "neovagina"; "Vaginal neoplasms"; "Squamous carcinoma"; "HPV infection" was performed. Results: 14 studies were finally included; seven corresponded to squamous cell carcinoma, three to adenocarcinoma and four reported HPV infection only. All of the squamous cell carcinomas were at advanced stages due to local or lymphatic compro- mise and received radiotherapy with concomitant chemotherapy or radical surgery. The prognosis was bad in three of the cases. Patients with adenocarcinoma also presented with advanced lesions due to local extensión and received surgical treatment and two cases received concomitant chemotherapy. Only one patient was followed-up for five years or more. HPV infection is common in women who underwent neovagina reconstruction. Conclusions: Patients with neovagina are susceptible to develope squamous carcinomas or adenocarcinomas depending if skin or intestinal tissue grafts are used. According to local compromise at the time of diagnosis, radical or combined treatments are required. Which screening strategies for HPV, squamous cell carcinomas and adenocarcinoma is to be investigated.

TITULO: CARCINOMA EPIDERMOIDE DE NEOVAGINA EN PACIENTE CON SÍNDROME DE MAYER- ROKITANSKY-KÜSTER-HAUSER. REPORTE DE UN CASO Y REVISIÓN DE LA LITERATURA. Objetivo: Presentar el caso de una paciente con síndrome de Mayer-Rokitansky-Küster-Hauser, con diagnóstico de carcinoma escamoso en neovagina, y realizar una revisión de la literatura del tratamiento y pronóstico de las neoplasias o la infección por VPH de tejidos neovaginales en mujeres transgénero o con síndrome MRKH. Materiales y métodos: Mujer de 56 años de edad que consulta en un hospital universitario regional de la ciudad de Sevilla (España). Tras la exploración clínica se aprecia una tumoración exofítica en fondo de vagina, con resultado de biopsia de carcinoma escamoso y cultivo positivo para virus del papilloma humano (VPH) tipo 16. Se realizó una búsqueda bibliográfica en la base de datos Medline vía PubMed, con los términos: "congenital abnormalities"; "mullerian aplasia"; "neovagina"; "vaginal neoplasms"; "squamous carcinoma"; "HPV infection", de reportes y series de caso, y estudios observacionales publicados desde el año 2000 hasta octubre de 2019 en inglés y español. Resultados: Se incluyeron 14 estudios; de estos, siete correspondieron a carcinoma escamocelular, tres a adenocarcinoma y cuatro informan infección solo por VPH. Todos los carcinomas escamocelulares presentaban estadios avanzados por compromiso local o linfático y recibieron radioterapia con quimioterapia concomitante o cirugía radical. El pronóstico fue malo en tres de los casos. Las pacientes con adenocarcinoma también presentaron lesiones avanzadas con compromiso local, el tratamiento fue quirúrgico, con quimioterapia concomitante en dos de los casos. Solo una paciente tuvo seguimiento mayor a cinco años. La infección por VPH es frecuente en mujeres sometidas a construcción de neovagina. Conclusiones: Las pacientes con neovagina son susceptibles de desarrollar carcinomas escamosos si se utilizaron injertos cutáneos, o adenocarcinomas en aquellas en las que se reconstruyó la vagina a partir de injertos tisulares intestinales. Dado que al momento del diagnóstico presentan compromiso local, a menudo requieren tratamientos radicales o combinados. Se debe investigar cuáles son las mejores estrategias de tamizaje de VPH, cáncer escamoso y adenocarcinoma en este tipo de pacientes.

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Abstract Melanomas of the female genital tract may occur in the vulva, the vagina, the ovary or the cervix.Pregnancy has been considered an aggravating factor in the evolution and prognosis of melanoma. A 35-year-old female presented with vaginal bleeding 2 months after a term cesarean delivery. An endovaginal ultrasound revealed a lesion in the uterine cervix. The pathological report revealed a small round-cell neoplasm, and the immunohistochemistry confirmed the diagnosis of malignant melanoma. A positron emission tomography revealed an expansive hypermetabolic lesion centered on the cervix, and hypermetabolic lesions in the liver and right kidney. Non-surgical treatment was provided, with biochemotherapy followed by ipilimumab and nivolumab. The patient died one year later. Postpartum vaginal bleeding, even if late-onset, should be investigated, as it may be a pregnancy-associated malignant melanoma, which has a poor prognosis.

Resumo Melanomas do trato ginecológico podem ocorrer na vulva, vagina, ovário ou cérvix. A gravidez é considerada um fator agravante na evolução e prognóstico do melanoma. Uma mulher de 35 anos de idade apresentou sangramento vaginal 2 meses após o parto por cesariana a termo. Uma ultrassonografia endovaginal mostrou lesão no colo uterino. O exame anatomopatológico mostrou uma pequena neoplasia de células redondas, e a imuno-histoquímica confirmou o diagnóstico de melanoma maligno. A tomografia por emissão de pósitrons mostrou lesão hipermetabólica expansiva centrada no colo do útero,e lesões hipermetabólicas no fígado e no rim direito. O tratamento não cirúrgico foi feito com bioquimioterapia seguida de ipilimumab e nivolumab. A paciente morreu um ano depois. Sangramentos vaginais pós-parto,mesmo que tardios,devem ser investigados,pois podem ser um melanoma maligno associado à gravidez, o qual tem um mau prognóstico.

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OBJECTIVE: To assess the value of vaginal screening cytology after hysterectomy for benign disease. METHODS: This cross-sectional study used cytology audit data from 2,512,039 screening tests in the metropolitan region of Campinas from 2000 to 2012; the object was to compare the prevalence of abnormal tests in women who had undergone a hysterectomy for benign diseases (n=53,891) to that of women who had had no hysterectomy. Prevalence ratios (95% confidence intervals, 95% CI) were determined, and chi-square analysis, modified by the Cochrane-Armitage test for trend, was used to investigate the effects of age. RESULTS: The prevalence of atypical squamous cells (ASC), low-grade squamous intraepithelial lesion (LSIL), and high-grade squamous intraepithelial lesion or squamous-cell carcinoma (HSIL/SCC) was 0.13%, 0.04% and 0.03%, respectively, in women who had undergone hysterectomy, and 0.93%, 0.51% and 0.26% in women who had not undergone hysterectomy. The prevalence ratios for ASC, LSIL and HSIL/SCC were 0.14 (0.11-0.17), 0.08 (0.06-0.13) and 0.13 (0.08-0.20), respectively, in women with a hysterectomy versus those without. For HSIL/SCC, the prevalence ratios were 0.09 and 0.29, respectively, for women <50 or ≥50 years. The prevalence rates in women with a previous hysterectomy showed no significant variation with age. CONCLUSION: The prevalence rates of ASC, LSIL and HSIL/SCC were significantly lower in women with a previous hysterectomy for benign disease compared with those observed in women with an intact uterine cervix. This study reinforces the view that there is no evidence that cytological screening is beneficial for women who have had a hysterectomy for benign disease.

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A neoplasia intraepitelial de vagina (NIVA) é uma condição pré-maligna rara do epitélio vaginal, sua incidência corresponde a 0,2 casos por 100.000 mulheres, classifica-se em NIVA I, II, III esta última tem um potencial de invasão de 9 a 12%. O diagnóstico é feito pela citologia, colposcopia, histopatologia. Todos os métodos terapêuticos tem uma taxa razoável de sucesso e a taxa de recorrência varia entre 10 e 42%. O tratamento pode ser: cirúrgico, ablativo, radioterápico, clínico e expectante. O excisional tem preferência por fornecer peça para análise histopatológica excluindo a doença invasiva apresentando as melhores taxas de sucesso entre 66% a 83% . A ablação é indicada quando a suspeita de invasão foi afastada e é a modalidade de eleição nas mulheres jovens, a eficácia varia entre 69 a 87%. A radiação tem uma taxa de sucesso entre 69 a 100%; porém, as complicações giram em torno de 36%. Pela sua praticidade o tratamento feito com os agentes tópicos tem ganhado espaço terapêutico na abordagem da NIVA. Não existe evidência científica quanto a melhor forma e o tempo de seguimento das mulheres com NIVA. Qualquer que seja a opção de tratamento utilizada um seguimento longo deve ser preconizado.(AU)

Vaginal intraepithelial neoplasia (VAIN) is an uncommon premalignant condition of the vaginal epithelium, its incidence is found to be 0.2 per 100.000 women, this condition is classificated in VAIN I, II and III, the lifetime risk of transformation to invasive carcinoma has been reported as 9 to 12%. The diagnosis was done by cytology, colposcopy and histology. All the therapeutics modalities have a successful cure rate and the recurrence ranges are between 10 to 42%. The treatment modalities are: excisional, ablative, radiotherapic, clinical and expectante. Excisional has preference as it could exclude invasion disease and has the best success rate, 66 to 83%. Ablation has preference in young women with no suspect of invasion, with efficacy ranging between 69 to 87%. The cure rate of radiotherapy is high as 69 to 100% but this modality has 36% morbidity rate. Treatment with topical agents constitutes a promising option in VAIN management. There is no scientific evidence of what kind follow-up is better. Whatever treatment modality is used long-term follow-up is essential.(AU)

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Vaginal metastases of colonic origin are exceedingly rare. When present, the prognosis is poor, and most individuals do not survive past 40 months. Surgical excision and radiotherapy have been used to treat this type of lesion. Case: A 67-year-old woman went to the Oncology Surgery Service with complaints of vaginal discharge and local pain. On physical examination, a 2.5 cm nodular lesion was found in the vagina. She had undergone a right hemicolectomy for a right colon cancer three months earlier. Punch biopsy was performed, and histological examination of the specimen showed metastasis of colonic adenocarcinoma. Subsequently, she underwent both radical wide excision and localized adjuvant radiotherapy. Four years later, the patient is asymptomatic, with no signs of local or systemic recurrence. Despite the rarity of this entity and its usually poor outcome, surgical treatment for isolated vaginal metastases of colonic origin is an appropriate therapeutic option with effective local control associated with low morbidity.

A metástase vaginal de origem colônica é considerada um evento extremamente incomum. Quando presente, o prognóstico é negativo, haja vista que a maioria dos indivíduos não sobrevive mais que 40 meses. A excisão cirúrgica ou até mesmo a radioterapia têm sido usadas para o tratamento desse tipo de lesão. Caso: Paciente de 67 anos procurou o Serviço de Oncocirurgia com queixas de leucorreia e dor. Ao exame físico apresentava lesão nodular de 2,5 cm em vagina. Como antecedente pessoal havia sido submetida a uma hemicolectomia direita por câncer de cólon direito (três meses). Subsequentemente realizou-se uma biópsia por punch, cujo exame histológico demonstrou tratar-se de uma metástase de adenocarcinoma de cólon. Isolada, a paciente foi submetida a uma ressecção ampla da lesão que foi complementada com radioterapia localizada. Após quatro anos, a paciente se apresenta assintomática e sem sinais de recidiva local ou sistêmica. Apesar da raridade da presente entidade e sua péssima evolução, o tratamento cirúrgico da metástase isolada de vagina de origem colônica representa uma opção terapêutica adequada, com eficaz controle local e está associada à baixa morbidade.

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La infección anogenital por el virus del papiloma humano (VPH) es la infección de transmisión sexual mas frecuente en todo el mundo. En los humanos se han identificado alrededor de 100 genotipos de los cuales unos 40 infectan la región ano-genital. Los 15 genotipos de alto riesgo, son causa necesaria del cßncer cervical y han sido implicados como agentes carcinogénicos de la vulva, vagina, pene, ano y región orofaríngea. Los VPH de bajo riesgo producen las verrugas genitales (condilomas) y la papilomatosis respiratoria recurrente en hombres y mujeres. Se calcula que unas 300 millones de mujeres en el mundo portan la infección por VPH. El advenimiento de las vacunas profilßcticas contra el VPH representa una estrategia prometedora en la prevención de las enfermedades relacionadas con este virus.

Anogenital human papillomavirus infection is the most frequent sexually transmitted disease. Around one hundred genotypes have been identified in humans, and 40 infect the genitalia and anal regions. Fifteen genotypes, classified as high-risk HPVs, are the necessary cause of cervical cancer and have been involved as carcinogenic agents for cancer of the vulva, vagina, anus, penis, and oropharyngeal cavity. Low-risk HPVs are the causative agents of genital warts, and recurrent respiratory papillomatosis in both men and women. The number of women harboring HPV-DNA worldwide is estimated to be 300 million. The recently introduced prophylactic HPV vaccines represent a hopeful strategy to prevent HPV infection and HPV-related diseases.

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La vacuna profilßctica contra el virus del papiloma humano (VPH) constituye la herramienta de salud pública mßs promisoria para la prevención primaria de cßncer de cuello uterino. La vacunación de mujeres antes de haber adquirido la infección viral tiene un gran impacto en la prevención de lesiones pre- eoplßsicas y cßncer de cuello uterino. Las vacunas actuales no eliminan completamente el riesgo de cßncer de cérvix, por lo tanto las mujeres vacunadas como las que no alcancen a recibir la vacuna, se les debe seguir ofreciendo los programas de detección temprana. Las estrategias que incluyen la combinación de vacunación con alta cobertura de adolescentes y tamización con métodos mßs sensibles que la citología, tales como la prueba de VPH, pueden ser mßs costo-efectivas que las estrategias actualmente utilizadas. La inefectividad de los actuales programas de tamización en países latinoamericanos incluido Colombia, amerita su evaluación inmediata a la luz de la disponibilidad de nuevos métodos que son costo-efectivos en países en desarrollo tales como la prueba de VPH y la inspección visual y tratamiento inmediato para mujeres con dificultades de acceso oportuno al tratamiento.

Prophylactic human papillomavirus (HPV) vaccine is the most promissory public health tool for primary prevention of cervical cancer. Immunization of females before the acquisition of HPV infection has the greatest impact in preventing pre-neoplasic lesions and cervical cancer. Current HPV vaccines do not eliminate cervical cancer risk, therefore, screening should continue covering vaccinated as well as women that do not get the vaccine. The strategies that include combination of high-coverage vaccination of HPV-unexposed adolescents with screening using methods with higher sensitivity than cytology as HPV test may be more cost-effective than the strategies currently used. The cytology-based screening programs of Latin America countries including Colombia are very ineffective. The evidence in favor of the cost-effectiveness of other screening strategies such as HPV tests and visual inspection followed by immediate treatment for women with difficult access to health care services in developing countries warrants the immediate revision of the current strategies.

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Na pratica ginecológica diária, a vulva e a vagina são examinadas durante inspeção visual, entretanto, há situações em que isso não é possível ou que se necessita determinar a extensão de umalesão através de métodos de imagem. A ressonância magnética é um método excelente e cada vez é mais indicado na avaliação de alterações da vulva e vagina, em virtude da sua capacidade deavaliação multiplanar e alto contraste tecidual, fornecendo informações que auxiliam o ginecologista. Outros métodos de imagem que podem ser indicados são a ultra-sonografia e a tomografia computadorizada da pelve. Este trabalho pretende, de forma sintética, analisar as principais alterações vulvo-vaginais que podem ser identificadas e diagnosticadas pelo radiologista.

In gynecological daily practices, the vulva and vagina are examined during physical examination, however there are situations where this is not possible or it is needed to determine the extension of an injury through imaging methods. The magnetic resonanceimaging is an excellent cross-sectional modality for evaluation the alterations of vulva and vagina due its multiplanar evaluation and high tecidual contrast. Other cross-sectional modalities are ultrasound and enhanced computed tomography. This paper intends togive an overview of vaginal and vulvar pathology that can be identifiedby the radiologist.

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Rabdomiossarcoma é o sarcoma de partes moles, mais comum na infância, portanto de rara ocorrência em adultos e localiza-se no trato genital feminino. Entre seus subtipos, destaca-se como mais freqüente o embrionário. Representa um tumor agressivo, de difícil diagnóstico e tratamento envolvendo excisão cirúrgica, radioterapia e quimioterapia. Os autores apresentam um caso de rabdomiossarcoma embrionário localizado em vagina, enfatizando os aspectos relevantes sobre o tema.

Rhabdomyosarcoma is the most common soft tissue sarcoma of childhood, although it is rare in adults and in the female genital tract. Among its subtypes, embryonal distinguish as the most frequent one. It represents an aggressive tumor, with difficult diagnostic and its treatment includes surgical excision, radiotherapy and chemotherapy. The authors present a case of embryonal rhabdomyosarcoma localized in vagina, emphasizing relevant aspects about the topic.

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Se realizó una variante quirúrgica en una paciente con cáncer recto-vaginal, con infiltración del tercio inferior y cara lateral derecha del recto, muy próximo al esfínter del ano. La técnica consistió, previo diagnóstico por biopsia, en realizar excérecis del tumor que comprometió al parapeto derecho y el tercio inferior de vagina, terminando con una colostomía perineal, conservando algunas fibras del esfínter del ano. Se dejó drenaje en ambos lados y se reconstruyó resto de la vagina. Se logró buena continencia rectal del paciente, con buen estado de satisfacción. No hubo complicaciones y actualmente defeca sin dificultad. Ha tenido seguimiento por consulta de Oncoginecología del Hospital III Congreso de Pinar del Río. La intervención se llevó a cabo en una hora.

A surgical alternative was performed in a patient suffering from rectovaginal cancer infiltrating the lower third and lateral right aspect of the rectum, so closed to anal sphincter. Operative technique consisted of a previous diagnosis by biopsy, besides, exceresis of the tumor that compromised right pararectum and lower third of vagina, ending in perineal colostomy preserving some fibers of anal sphincter. Drainage was performed in both sides and the rest of the vagina was reconstructed. A good rectal continence and well being were obtained, observing no complications, the patient defecates without difficulties, this case is followed up at "III Congreso Hospital" in Pinar del Rio. Operative procedures lasted an hour.