Brachytherapy facilitates closure of malignant vesicovaginal fistulas: A case report and literature review
Rationale:
Malignant vesicovaginal fistula (MVF) usually result from the progression of bladder cancer or cervical cancer. Since the fistula openings are filled with malignant tumors, there are currently no effective treatment options or valuable research findings to achieve fistula healing, making it a difficult and intractable issue in clinical practice. In this report, we present an innovative and practical procedure to address this issue.
Patient concerns:
A patient with recurrent cervical cancer after treatment presented with persistent vaginal bleeding. On physical examination, the vagina was found to be filled with tumors that bled on palpation, and a large, hard mass was palpable in the abdomen.
Diagnoses:
The initial magnetic resonance imaging revealed that the patient’s lower abdomen and pelvic cavity were filled with tumors, the bladder was invaded by the tumor, and a vaginal fistula was present.
Interventions:
Sequential chemotherapy in combination with immunotherapy was carried out to facilitate the tumor downgrading, allowing subsequent interstitial brachytherapy conducted.
Outcomes:
Following a dose delivery of 24 to 40 Gy in 4 fractions over 2 weeks, the MVF was found unexpectively completely closed, and the hallmark symptom of urine leakage from the vargina resolved.
Lessons:
This case highlights the potential of brachytherapy as a promising and effective treatment modality for MVF. Further studies are warranted to validate these findings and establish standardized protocols.