An unusual case of post-menopausal bleeding

Abstract Background Metastasis from Renal cell carcinoma at presentation is seen in nearly one fifth of the patients and commonly occur to lung, bone and liver. Synchronous vaginal and cervical metastasis is extremely rare. Several pathways have been proposed of which blood reflux from left renal ve...

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Main Authors: Roli Purwar, Jyothi Kanugonda, Mridula Shukla, Manoj Pandey
Format: Article
Language:English
Published: BMC 2025-02-01
Series:World Journal of Surgical Oncology
Subjects:
Online Access:https://doi.org/10.1186/s12957-025-03684-7
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author Roli Purwar
Jyothi Kanugonda
Mridula Shukla
Manoj Pandey
author_facet Roli Purwar
Jyothi Kanugonda
Mridula Shukla
Manoj Pandey
author_sort Roli Purwar
collection DOAJ
description Abstract Background Metastasis from Renal cell carcinoma at presentation is seen in nearly one fifth of the patients and commonly occur to lung, bone and liver. Synchronous vaginal and cervical metastasis is extremely rare. Several pathways have been proposed of which blood reflux from left renal vein to ovarian vein is most plausible. The prognosis is usually very poor as they are often associated with disseminated metastasis. Case presentation A 55-year-old women presented with post-menopausal vaginal bleeding, on examination a smooth mass occupying the vagina and obscuring the view of cervix with normal mucosa was found. Biopsy and Immunohistochemistry showed it to be renal cell carcinoma. Further investigations lead to identification of left renal mass with pulmonary, vaginal and cervical metastasis. Patient was started on Pazopanib 800 mg PO per day, and was lost to follow-up. Conclusion Vaginal metastasis presenting as post-menopausal bleeding is one of the rarest presentation of renal cell carcinoma with only 3 cases reported in literature before this. Metastatic tumors to the vagina are more common than primary tumors and are mostly from cervix, endometrium and ovary. A high index of suspicion and through examination and investigation is the key to correct diagnosis and management.
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series World Journal of Surgical Oncology
spelling doaj-art-8274dfd9c4d340c19c1319bf154e7fdd2025-02-09T12:39:54ZengBMCWorld Journal of Surgical Oncology1477-78192025-02-012311610.1186/s12957-025-03684-7An unusual case of post-menopausal bleedingRoli Purwar0Jyothi Kanugonda1Mridula Shukla2Manoj Pandey3Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu UniversityDepartment of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu UniversityDr. Lalpath Labs Ltd.Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu UniversityAbstract Background Metastasis from Renal cell carcinoma at presentation is seen in nearly one fifth of the patients and commonly occur to lung, bone and liver. Synchronous vaginal and cervical metastasis is extremely rare. Several pathways have been proposed of which blood reflux from left renal vein to ovarian vein is most plausible. The prognosis is usually very poor as they are often associated with disseminated metastasis. Case presentation A 55-year-old women presented with post-menopausal vaginal bleeding, on examination a smooth mass occupying the vagina and obscuring the view of cervix with normal mucosa was found. Biopsy and Immunohistochemistry showed it to be renal cell carcinoma. Further investigations lead to identification of left renal mass with pulmonary, vaginal and cervical metastasis. Patient was started on Pazopanib 800 mg PO per day, and was lost to follow-up. Conclusion Vaginal metastasis presenting as post-menopausal bleeding is one of the rarest presentation of renal cell carcinoma with only 3 cases reported in literature before this. Metastatic tumors to the vagina are more common than primary tumors and are mostly from cervix, endometrium and ovary. A high index of suspicion and through examination and investigation is the key to correct diagnosis and management.https://doi.org/10.1186/s12957-025-03684-7Renal cell carcinomaVaginal metastasisVenous refluxCervixKidneyPazopanib
spellingShingle Roli Purwar
Jyothi Kanugonda
Mridula Shukla
Manoj Pandey
An unusual case of post-menopausal bleeding
World Journal of Surgical Oncology
Renal cell carcinoma
Vaginal metastasis
Venous reflux
Cervix
Kidney
Pazopanib
title An unusual case of post-menopausal bleeding
title_full An unusual case of post-menopausal bleeding
title_fullStr An unusual case of post-menopausal bleeding
title_full_unstemmed An unusual case of post-menopausal bleeding
title_short An unusual case of post-menopausal bleeding
title_sort unusual case of post menopausal bleeding
topic Renal cell carcinoma
Vaginal metastasis
Venous reflux
Cervix
Kidney
Pazopanib
url https://doi.org/10.1186/s12957-025-03684-7
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