CASE REPORTS Vaginal Carcinoma in a Female-to-Male Transsexual Thilo Ludwig Schenck, MD, BBAE (Hons),* Thomas Holzbach, MD,* Niko Zantl, MD, PhD, † Christopher Schuhmacher, MD, PhD, ‡ Markus Vogel, MD, § Stefan Seidl, MD, ¶ Hans-Gunther Machens, MD, PhD,* and Riccardo Enzo Giunta, MD, PhD* *Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; † Urologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; ‡ Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; § Frauenklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; ¶ Institut für Allgemeine Pathologie und Pathologische Anatomie der Technischen Universität München, Munich, Germany DOI: 10.1111/j.1743-6109.2009.01686.x A B S T R A C T Introduction. Sex reassignment surgery (SRS) can be considered a reasonable and secure treatment for transse alism, today. Because the population of patients who have received SRS is growing steadily, it can be expecte the number of patients who present with diseases specific to their original gender will increase as well. Aim. In female-to-male transsexuals, vaginalcancer 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 patientpresented with vaginal cancer,which infiltrated rectum and bladder and also showed involvement of inguinallymph 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 sympto 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 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 ovaries, cervix and vagina, will prevent cancer of these structures. When it comes to surgery in SRS patients w malignancies, an interdisciplinary approach should be chosen. Schenck TL, Holzbach T, Zantl N, Schuhma C, Vogel M, Seidl S, Machens H-G, and Giunta RE. Vaginal carcinoma in a female to male transsexu Med 2010;7:2899–2902. Key Words. Transsexualism; Sexual Reassignment Surgery; Carcinoma of the Vagina; Female to Male Transsexu Introduction S ince the 1930s, when the first reports of sex reassignment surgeries (SRS) were published, the number ofprocedures being performed has risen continuously [1]. Indicationsand surgical techniquesfor SRS have constantlyimproved so that SRS can be considered areasonable and secure treatment for transsexualism, today [2–4]. After SRS, transsexuals are still at risk of devel- oping many gender-specificdiseasesin the remaining organs of their genetic gender. The risk factor for mostof these gender-specific diseases can be expected to be similar to risk factors in the population of the patients’ genetic gender. However,choice of surgical approach for SRS and long-term hormone exposure lead to changes in the risk profiles after SRS. Ovary resection is frequently performed and might play a role in 2899 © 2010 International Society for Sexual Medicine J Sex Med 2010;7:2899–2902