My wife (45 year old F, 3 children vaginally delivered, last in 1988, 2003 Hysterectomy for prolapsed uterus, fibroids and dysplasia) was diagnosed last week with an approx 3cm tumor that through biospy as a Clear Cell Carcinoma of the bladder and now invaded the vagina. Painful, frequent and low volume urination was the only symptom, onset 6 months ago, and she spent 3 months eliminating all other conditions. No other symptoms were diagnosed. CT scan and chest Xray are negative for nodal and metastaces.
Location is under the trigon area with some indication of urethreal penetration. Radical Cystectomy with partial vaginal resection is scheduled later this month (3/06) at Mayo Clinic.
At this point no other pathology has been reported. Its likely a PEComa of the bladder, invading the vaginal epitholioid as well (this is my guess, I’m not an oncologist, but have worked 10 years in clinical cancer research in my recent past).
Surgery yesterday revealed 2 positive lymph nodes each ~ 2cm in size. also the tumor size was now estimated at 5cm in size. Margins were good, but now they grade the cancer at T4aN2M0.
Vagina and Bladder were radically resected, but instead of an Indiana pouch, the surgeon’s advised that with the likely chemo protocol, a ileal conduit stoma was a better approach.