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Case Reports
. 2024 Nov 11;16(11):e73420.
doi: 10.7759/cureus.73420. eCollection 2024 Nov.

Intersecting Pathologies: Vulvar Cancer Complicated by a Fusobacterium necrophorum Infection

Todd R Anderson  1 , Emily Carletto  1 , Valeria Barreto-Nadal  2 , Emily Langston  3 , Michael Jones  4
Affiliations
Case Reports

Intersecting Pathologies: Vulvar Cancer Complicated by a Fusobacterium necrophorum Infection

Todd R Anderson et al. Cureus. .

Abstract

Vulvar cancer represents a small minority of annual cancer cases in America. This malignancy affects more than the physical health of the patient. This malignancy also has a negative impact on women's psychological and sexual health. This case pertains to a 49-year-old woman (G1P1001) who presented with right groin pain, fever, and chills for three days. She reported experiencing vaginal bleeding during the intercourse and had been able to palpate a mass inside her vagina for the past five years. A pelvic exam revealed a 6 cm tender mass on the left vaginal wall, which was friable and hemorrhagic on palpation, along with associated lymphadenopathy. The patient was taken to the operating room where the exophytic mass and lymphadenopathy were biopsied. Necrotic lymph nodes were removed and sent for pathology. Pathology confirmed moderately differentiated squamous cell carcinoma of the vulva. The lymph node pathology report also indicated that the necrotic nodes were infected with Fusobacterium necrophorum. Given the extent of the tumor, it was deemed largely inoperable, and the patient was recommended local radiation therapy. The patient was diagnosed with stage III vulvar cancer. This case highlights the intersection of gynecology-oncology and infectious disease, with a never-before-documented bacterial infection in the context of vulvar cancer. Fusobacterium necrophorum has been previously associated with colorectal cancers, liver abscesses, and ovarian abscesses. Further ingestion is needed to understand the role of this pathogen in the development of vulvar cancer.

Keywords: cancer; case report; fusobacterium necrophorum; hpv; vulvar cancer; women’s health.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. GME Research Program issued approval GME Case Report #: 0135-24. Dr. Michael Jones Todd Anderson Title: Vulvar Cancer Complicated by Fusobacterium necrophorum Infection: A Case Report Investigator: Todd Anderson GME Case Report #: 0135-24 Effective Date: August 22, 2024. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Coronal section of abdomen MRI, the green markers showing the large inguinal lymphadenopathy that measured 3.5 cm x 4.9 cm.
Figure 2
Figure 2. Sagittal section of Pelvic MRI demonstrating the vaginal carcinoma measuring 4.3 cm x 2.7 cm.
Figure 3
Figure 3. Transverse section of the pelvis MRI demonstrating the malignancy measuring 4.3 cm x 2.7 cm.
See this image and copyright information in PMC

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