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Vaginal Carcinoma in a Female-to-Male Transsexual

Authors

  • Thilo Ludwig Schenck MD, BBAE (Hons),

    1. Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany;
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  • Thomas Holzbach MD,

    1. Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany;
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  • Niko Zantl MD, PhD,

    1. Urologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany;
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  • Christopher Schuhmacher MD, PhD,

    1. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany;
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  • Markus Vogel MD,

    1. Frauenklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany;
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  • Stefan Seidl MD,

    1. Institut für Allgemeine Pathologie und Pathologische Anatomie der Technischen Universität München, Munich, Germany
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  • Hans-Gunther Machens MD, PhD,

    1. Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany;
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  • Riccardo Enzo Giunta MD, PhD

    Corresponding author
    1. Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany;
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Riccardo Enzo Giunta, MD, PhD, Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany. Tel: 089/4140-2171; Fax: 0049 89 4140-4869; E-mail: R.Giunta@lrz.tu-muenchen.de

ABSTRACT

Introduction.  Sex reassignment surgery (SRS) can be considered a reasonable and secure treatment for transsexualism, today. Because the population of patients who have received SRS is growing steadily, it can be expected that the number of patients who present with diseases specific to their original gender will increase as well.

Aim.  In female-to-male transsexuals, vaginal cancer has not been reported so far. This article reports, to our knowledge, the first case of a female-to-male transsexual who developed vaginal cancer.

Methods.  Eighteen years after receiving female-to-male SRS, the patient presented with vaginal cancer, which infiltrated rectum and bladder and also showed involvement of inguinal lymph nodes. Surgery consisted of an anterior and posterior pelvic demolition and extended lymphadenectomy with preservation of the penoid and reconstruction of the pelvic defect with multiple flaps.

Results.  The tumor was removed completely (R0), and 2 years after surgery, the patient has no signs or symptoms of tumor recurrence and enjoys good quality of life.

Conclusions.  In SRS patients, diseases of their original gender should always be considered and patients should be encouraged to participate in screening programs. When choosing the surgical approach for SRS, the risks for developing cancer from remaining structures of the genetic gender should be considered. Of course, removal of e.g., ovaries, cervix and vagina, will prevent cancer of these structures. When it comes to surgery in SRS patients with malignancies, an interdisciplinary approach should be chosen. Schenck TL, Holzbach T, Zantl N, Schuhmacher C, Vogel M, Seidl S, Machens H-G, and Giunta RE. Vaginal carcinoma in a female to male transsexual. J Sex Med 2010;7:2899–2902.

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