Poorly differentiated vaginal adenocarcinoma with aggressive behavior—Pap smear findings

Vaginal carcinoma is a rare condition. In this report, we describe a case of a poorly differentiated aggressive adenocarcinoma in a woman with a three month history of vaginal bleeding and a negative Pap smear done six months prior to her consultation. Specular examination showed a normal cervix, but there was a bleeding ulcer (2 cm in diameter) in the upper third of the vagina. Cytology revealed poorly differentiated atypical cells, and the biopsy established a diagnosis of vaginal adenocarcinoma with little differentiation. Within two months, the patient died without diagnosis of a primary tumor site other than the vagina.