Vaginal tumor recurrence

Ultrasonography and CT have only a hmited role in detecting recurrent or residual vaginal tumor because they rely on the configuration of the lesion as the only criterion. The sensitivity of bofli modaUties is too low for differentiation of tumor from posttherapeutic changes and for the detection of small tumors. The accuracy of the cHnical examination is also limited, in particular when postoperative scar tissue is present. 

Fig. 10.27. Late recurrence of granulosa cell tumor. Transaxial T2-weighted image in a 45-year-old patient with a history of hysterectomy and resection of a granulosa cell tumor 16 years before. Recurrent granulosa cell tirnior is identified as a solid and cystic lesion above the vaginal vault. The right border is well defined, the left posterior margin shows irregular contours arrow) extending to the posterior pelvic sidewall. Small amounts of ascites are demonstrated in the pelvis. At surgery, invasion of the iliac internal vessels was confirmed...

Recurrent tumors after surgery are seen as a soft tissue mass in the region of the vaginal vault, usually with involvement of the adjacent parametrium. After radiotherapy, the tumor is seen as a mass within the cervix. The involvement of the pelvic floor or the sidewalls is essential for planning resection of primary and recurrent tumors. 

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