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Case Report
Primary mucinous adenocarcinoma intestinal type of the vulva arising at site of prior vulvar Crohn’s disease: A case report and review of the literature
1 Cleveland Clinic Akron General Obstetrics and Gynecology, Akron, OH, USA
2 Cleveland Clinic Obstetrics and Gynecology Institute, Cleveland, OH, USA
3 Cleveland Clinic Obstetrics and Gynecology Institute, Section of Gynecologic Oncology, Cleveland, OH, USA
4 Cleveland Clinic Akron General Hematology and Medical Oncology, Akron, OH, USA
5 Cleveland Clinic Akron General Obstetrics and Gynecology, Division of Gynecologic Oncology, Akron, OH, USA
Address correspondence to:
Lisa Rauh-Benoit
MD, MPH, 9500 Euclid Avenue, Cleveland, Ohio 44195,
USA
Message to Corresponding Author
Article ID: 100182Z08SW2024
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How to cite this article
Waldrop S, Dinicu A, Kelley J, Sindel A, Rizzo A, Rauh-Benoit L. Primary mucinous adenocarcinoma intestinal type of the vulva arising at site of prior vulvar Crohn’s disease: A case report and review of the literature. J Case Rep Images Obstet Gynecol 2024;10(2):30–33.ABSTRACT
Introduction: Vulvar mucinous adenocarcinoma is a rare subtype that likely arises from atopic gastrointestinal tissue. The evaluation and treatment of this condition often requires a multidisciplinary approach.
Case Report: Our patient is a 55-year-old female with a history of Crohn’s disease who initially presented with a painless vulvar mass associated with occasional bleeding. Notably, the mass presented at the site of a prior rectovaginal fistula. A vulvar biopsy was performed with pathology consistent with intestinal type mucinous adenocarcinoma. Further workup was notable for imaging showing retroperitoneal and pelvic metastatic lymphadenopathy, hypermetabolic liver and bony metastases, and pulmonary nodules concerning for metastases. Following discussion at tumor board, the patient was recommended treatment with 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX), and bevacizumab. Unfortunately, prior to starting chemotherapy, the patient presented to the emergency department with dizziness and weakness and was found to have brain metastases. She ultimately elected to be discharged home on hospice care.
Conclusion: Vulvar mucinous adenocarcinoma is a rare subtype tumor with limited literature on treatment options. For these rare cases, clinicians can consider treatment modalities for colon carcinomas rather than vulvar carcinomas.
Keywords: Crohn’s disease, Mucinous adenocarcinoma, Vulvar cancer
SUPPORTING INFORMATION
Acknowledgments
Tatiana Buhtoiarova, MD for producing and providing pathology images
Author ContributionsSavannah Waldrop - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Andreea Dinicu - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Johanna Kelley - Revising it critically for important intellectual content, Final approval of the version to be published
Ariel Sindel - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Anthony Rizzo - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Lisa Rauh-Benoit - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Savannah Waldrop et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
