Vaginal Tumors Research Articles

A Case of Undifferentiated Carcinoma in a 2-Month Postpartum Reproductive Tract with a Rapid and Fulminant Course

Advanced carcinoma of the lower female reproductive tract is rare during pregnancy and the postpartum period. We here present a case of a 32-year-old Japanese woman, whose entire lower reproductive tract had been invaded by carcinomas as of 2 months after childbirth. She had been infertile, and pregnancy had been established by repeated embryo transfer. The gynecological cancer screening, which included Pap smear tests, was negative during the periods she underwent infertility treatment or during the first trimester. At 26 gestational weeks, the patient noticed uterine contractions concomitant with genital bleeding. Labor progressed slowly and steadily; thus, the pregnancy was ended by cesarean section at 29 weeks. At 2 months after childbirth, the patient experienced increased left abdominal pain and underwent a pelvic examination, revealing multiple pelvic masses and diffuse vaginal tumors causing stenosis. Vaginal tumors were biopsied, and histochemical analysis showed undifferentiated carcinoma with possible adenocarcinoma. Imaging modalities including CT, MRI, and PET-CT suggest that the carcinoma had invaded the entire reproductive tract, especially the uterine body, metastasized into the lungs and the ischial bones, and disseminated onto the peritoneum. She received multiple rounds of chemotherapy but died 6 months after childbirth. Taking into consideration the clinical feature and immunohistochemical profiles of the cancer cells, the endometrium is the most likely origin.

Laparoscopic Mitrofanoff Withradical Utethrectomy Withmartius FLAP Reconstructionforvaginal Tumour Infiltrating Urethra

<h3>Study Objective</h3> Laparoscopic Mitrofanoff with Radical Utethrectomy for Vaginal Tumour Infiltrating Urethra <h3>Design</h3> Laparoscopic. <h3>Setting</h3> Open and Laparoscopic. <h3>Patients or Participants</h3> One. <h3>Interventions</h3> Laparoscopic Mitrofanoff with Radical Utethrectomy with Martius Flap Reconstruction. <h3>Measurements and Main Results</h3> Tumour clearence with uterus and bladder preservation with continent pouch. <h3>Conclusion</h3> In locally advanced urethro vaginal tumours inspite of radical procedures like anterior exenteration we should consider preservation of bladder and uterus function by Laparoscopic Mitrofanoff procedure.

Cancer of the vagina: 2021 update.

Diagnosis of a primary vaginal cancer is rare, as most vaginal tumors are metastatic from another primary site. Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This is associated with persistence of high‐risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, as with cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer.

Changes in Hematological Parameters Associated with Vaginal Hyperplasia and Vaginal Tumors in Bitches

The aim of the study is to evaluate the changes in clinical, hematological and histopathological parameters of the bitches with vaginal hyperplasia (VH), vaginal tumors (VT) and healthy reproductive tract (H), respectively. The study groups formed as; group VH (n=9), group VT (n=10) and group H (n=13). All bitches were examined clinically (vaginal cytology, vaginoscopy), hematologically and histopatologically. The bitches in group H were in anestrus and the bitches in group VH and group VT were in oestrus. Reduced levels of RBC, HGB, HCT and increase in WBC were detected in group VT. The averages of HGB level in group VH was tended to be lower than group H (P=0.05) while the averages of HCT level in group VH was significantly lower than to group H. The averages of RBC, HGB, HCT and WBC were not significantly associated with the degree of vaginal fold prolapse (VFP) (P&amp;gt;0.05) while the averages of PLT and PCT in bitches with type 2 VH were tended to be higher than type 3 VH (P=0.07). The histopathological examination of the vaginal masses in group VH revealed thickening of squamous epithelium and significantly loose and edematous connective tissue in the lamina propria. Histological diagnosis of the tumors in group VT were fibroma (n=4), leiomyoma (n=3), peripheral nerve sheath tumor (n=1), transmissible venereal tumor (TVT) (n=1) and leiomyosarcoma (n=1). In conclusion, hematological changes in bitches with vaginal mass were evaluated and mild anemia and leukocytosis were determined in bitches with VH and VT. To our knowledge, this is the first study that demonstrates the detection of mild anemia in bitches with VH and the differences in PLT and PCT related to the degree of VFP.

Therapeutic irradiation in the management of gynecological cancer and predictability of radiation-induced complications

Background. Today, applying radiotherapy (RT) in management of both primary and secondary vaginal cancer (SVC) take pride of place in the spectrum of specialized treatments for cancer patients. Secondary vaginal tumors are more common (6% to 33%) in cervical cancer (CC) patients, while in uterine cancer (UC) occur in 8–10% of cases treated either surgically, or by means of radiotherapy, otherwise via a combination approach. Therefore, RT is administered in about 80% of primary vaginal cancer and particularly SVC patients. When using even the most advanced radiotherapy equipment implying the cutting-edge technologies, there is a risk of radiation-induced complications in healthy organs and tissues that fall under the irradiation area. Keeping in mind the key radiobiological paradigms makes it possible not only to predict the probability of tumor resorption upon radiation exposure, but also to assess the biological effectiveness of absorbed dose, as well as the risk of late radiation complications.&#x0D; Purpose – to enhance the effectiveness and assess the toxicity of SVC RT via ascertaining BT (brachytherapy) most suitable techniques depending on the type of ionizing radiation and exploring predictability of radiation-induced complications in terms of biomolecular cell properties.&#x0D; Materials and methods. Clinical study was performed at the National Cancer Institute Clinic (Radiation Oncology Department), using a high-energy BT unit with a HDR 192Ir source. The SVC patients (n = 106) were treated according to the developed BT methods. They had been pretreated for the CC (n = 65) with squamous cell carcinoma histologically diagnosed in the most cases or UC (n = 41) with histologically prevalent adenocarcinoma of a variable grade. Patients had a locally advanced pelvic tumor process with tumor staging II–III, T2-3N0-1M0. Along with clinical study the radiobiological research was conducted to count the apoptotic cells in both intact and irradiated peripheral blood lymphocytes (PBL), as well as the level of SH-groups of plasma proteins and peptides in gynecological cancer patients and healthy donors to predict the risk of radiation-induced complications.&#x0D; Results and discussion. Given the delayed effect of RT, the treatment effective- ness was analyzed immediately after RT session and also 3 months upon completion of the conservative therapy. Thus, positive tumor response upon three months of observation over time was registered in 67.9 ± 5.2% of patients in study group I, in 72.5 ± 6.9% in study group II, and in 51.3 ± 6.8% in comparison group. Hence the values in study groups were higher than in comparison group by 16.6% and 21.2% respectively. All patients tolerated BT satisfactorily. Neither general nor local rectum or bladder severe (above grade II) toxicities were noted both during treatment and over the next 3 months upon its completion in all the patients regardless of study group. Results obtained in radiobiological studies correlated with clinical and literature data.&#x0D; Conclusions. Decrease in manifestations of RT toxicity, namely of the ear- ly radiation reactions from interfacing critical organs was established in groups I and II vs comparison group I, especially in group I where a high- energy 192Ir source was used in the SBD irradiation mode of 3 Gy twice a week. The obtained results of the experimental study suggest that the content of SH-groups in blood plasma and the level of PBL apoptosis can be considered as additional predictive measures of radiosensitivity of non-malignant cells from the irradiated tumor environment.

Relationship of Urethral Dose and Genitourinary Toxicity Among Patients Receiving Vaginal High Dose Rate Interstitial Brachytherapy

AimsInterstitial brachytherapy (ISBT) plays an important role in the management of locally advanced gynaecological malignancies. However, the relationship between urinary toxicity and dose to the urethra is not well understood. We sought to evaluate the correlation between urethral dose and the incidence of genitourinary complications among patients undergoing vaginal high dose rate ISBT. Materials and methodsEighty-three patients treated with ISBT between August 2014 and April 2018 were retrospectively reviewed. CTCAE version 5.0 was used to grade toxicity. Individual treatment plans were evaluated to collect dose parameters. Urethral contours were added to the structure sets using a uniform 1 cm diameter brush and minimum doses to the hottest 0.1, 0.2 and 0.5 cm3 (D0.1cm3, D0.2cm3 and D0.5cm3) of the urethra were obtained. Total (ISBT ± external beam radiotherapy) equivalent doses in 2 Gy fractions (EQD2) received by the targets and organs at risk were calculated. Numerical counts (%) and medians (interquartile range) were used to characterise the data. Fisher's exact and the Mann–Whitney–Wilcox tests were used as appropriate. Receiver operator curve analysis was used to define the urethral threshold dose that correlated to genitourinary toxicity. ResultsThe median age and follow-up times were 67 years (59–75) and 25 months (16–37), respectively. Patients had predominantly primary endometrial (49%) and vaginal (37%) cancer, with four (5%) patients with metastatic rectal cancer to the vagina. Twenty-four of 79 (30%) patients experienced acute genitourinary toxicity and 34 of 71 (48%) experienced late genitourinary toxicity. In both analyses, the median urethral dose was significantly higher among those with toxicity. Receiver operator curve analysis indicated that D0.1cm3, D0.2cm3 and D0.5cm3 of the urethra were associated with the development of toxicity at doses >78, >71 and >62 Gy, respectively. ConclusionUrethral dose seems to predict genitourinary toxicity in ISBT of vaginal tumours. Further study with an expanded cohort and longer follow-up is warranted.

Clearance of established oropharyngeal and genital HPV tumors by mucosal vaccination via induction of multiple cytotoxic effector populations

Abstract High-risk type human papillomaviruses (HPV) are the underlying cause of &amp;gt;5% of all cancers including cervical and Head &amp; Neck cancers in which virus-encoded E6/E7 oncoproteins serve as tumor-specific antigens. Despite the success of prophylactic HPV vaccine, therapeutic strategies targeting the E6/E7 have been ineffective in established HPV+ tumors due mainly to inadequate antigen-specific immunity. Therefore, enhancing the therapeutic potential HPV vaccines to achieve curative efficacy is an unmet clinical need. We present here preclinical evidence for efficient clearance of immunocompetent HPV tumors at the vaginal (TC-1) and oral (mEER) mucosal tissues by intranasal vaccine using HPV16 E6 and E7 short peptides along with the combination of clinically relevant adjuvants QS-21 and CpG-ODN. This vaccine exhibited high therapeutic efficacy with &amp;gt;80% mice with oral or vaginal tumors showing regression as well as significant extended survival advantage over untreated mice or mice treated with vaccine containing single adjuvants. The analysis of immune correlates by multicolor flow cytometry showed robust increases in the overall as well as antigen-specific (E7 tetramer+) cytotoxic CD8 T cells expressing Granzyme B and/or IFNg in both intra-tumoral and systemic compartments in vaccine-treated mice. Furthermore, the intranasal vaccine containing the combination of adjuvants induced significant frequencies of a unique subpopulation of NK cells expressing CD11c, granzyme B and IFNg, termed NKDC. Our results suggest that mucosal HPV E6/E7 peptide vaccine formulation containing QS-21+CpG-ODN adjuvants may provide an effective therapeutic strategy for the treatment of patients with HPV+ oropharyngeal and cervical cancers.

Neuroendocrine tumor (NET) of the vagina in the light of WHO 2020 2-tiered grading system: clinicopathological report of the first described case.

Up to now, a vaginal well-differentiated neuroendocrine tumor (NET) has never been well described in the literature. A 2-cm vaginal nodule morphologically revealed a proliferation of mild to moderately atypical eosinophilic epithelioid cells, without tumor cell necrosis. Immunohistochemistry (IHC) showed positivity for CK (AE1/AE3), chromogranin A, and synaptophysin, focal positivity for CDX2, and negativity for PAX8 and TTF1. Metastatic origin was excluded by imaging and the morphological context with benign mucinous glands as present in the surgical resection specimen. Considering mitotic index and Mib1/Ki67 (8 mitoses/2 mm2; >20%), the case was diagnosed as vaginal NET G2 in the light of the WHO 2020 grading system for the gynecologic neuroendocrine neoplasms (NENs). Ranges of Mib1-Ki67 are not yet standardized. Currently, mitotic index and tumor cell necrosis were taken into consideration for the grading system. Gynecologic NENs still represent a diagnostic challenge. A clinico-radiologic workup and an appropriate diagnostic path ruling out the metastatic nature are mandatory to achieve the diagnosis.

Vaginal Squamous Cell Carcinoma Develops in Mice with Conditional Arid1a Loss and Gain of Oncogenic Kras Driven by Progesterone Receptor Cre

Oncogenic KRAS mutations are a common finding in endometrial cancers. Recent sequencing studies indicate that loss-of-function mutations in the ARID1A gene are enriched in gynecologic malignant tumors. However, neither of these genetic insults alone are sufficient to develop gynecologic cancer. To determine the role of the combined effects of deletion of Arid1a and oncogenic Kras, Arid1aflox/flox mice were crossed with KrasLox-Stop-Lox-G12D/+ mice using progesterone receptor Cre (PgrCre/+). Histologic analysis and immunohistochemistry of survival studies were used to characterize the mutant mouse phenotype. Hormone dependence was evaluated by ovarian hormone depletion and estradiol replacement. Arid1aflox/flox; KrasLox-Stop-Lox-G12D/+; PgrCre/+ mice were euthanized early because of invasive vaginal squamous cell carcinoma. Younger mice had precancerous intraepithelial lesions. Immunohistochemistry supported the pathological diagnosis with abnormal expression and localization of cytokeratin 5, tumor protein P63, cyclin-dependent kinase inhibitor 2A, and Ki-67, the marker of proliferation. Ovarian hormone deletion in Arid1aflox/flox; KrasLox-Stop-Lox-G12D/+; PgrCre/+ mice resulted in atrophic vaginal epithelium without evidence of vaginal tumors. Estradiol replacement in ovarian hormone-depleted Arid1aflox/flox; KrasLox-Stop-Lox-G12D/+; PgrCre/+ mice resulted in lesions that resembled the squamous cell carcinoma in intact mice. Therefore, this mouse can be used to study the transition from benign precursor lesions into invasive vaginal human papillomavirus-independent squamous cell carcinoma, offering insights into progression and pathogenesis of this rare disease.

27. A Case of Vaginal Yolk Sac Tumor in an 8 Year Old Girl with Didelphys Uterus

<h3>Background</h3> Vaginal yolk sac tumors are quite rare in children. They usually occur in young girls under the age of 3 and present with vaginal bleeding. We present a case where an initial exam under anesthesia revealed no evidence of a vaginal malignancy. However, due to ongoing symptoms, a re-evaluation revealed vaginal yolk sac tumor which had been concealed by a congenital anomaly. <h3>Case</h3> An 8 year old girl presented with a 3 month history of pre-pubertal vaginal bleeding. A workup revealed pre-pubertal hormonal levels, no evidence of vaginal infections or foreign objects and no concerns for sexual abuse. Imaging revealed a didelphys uterus with 2 cervixes and a 9mm collection of heterogeneous material which appeared to be within an obstructed left hemi-vagina. On vaginoscopy there was no visible blood, no distension of the left hemi-vagina that could be visualized, and no evidence of malignancy. Due to ongoing symptoms, exam under anesthesia was repeated in one year. On this exam a bulge was noted in the vagina. The vaginal septum was perforated and significant vaginal tumor was discovered within the left hemi-vagina. This was biopsied and found to be an extra-gonadal yolk sac tumor. She was subsequently referred to oncology and diagnosed with Stage III extra-gonadal yolk sac tumor with negative AFP. She received 4 cycles of cisplatin, bleomycin and etoposide (PEB). She underwent interval debulking of vaginal tumor, which was halted due to excessive bleeding from the tumor. She underwent 2 additional cycles of PEB followed by excision of the vaginal septum. At that time there was no further visible tumor and no tumor was identified on histologic evaluation of the septum. <h3>Comments</h3> This case illustrates difficulty diagnosing a vaginal tumor due to a congenital anomaly. It is critical to continue to follow patients with pre-pubertal bleeding if there is no etiology discovered initially. Though malignancy is a rare cause of pre-pubertal vaginal bleeding, it is important to reconsider this in cases which include congenital anomalies that may delay the diagnosis.

Paraurethral Skene's cyst case in puberty

Paraurethral cysts are rare. Vaginal wall inclusion cyst, scene gland abscess, gartner duct cyst, ectopic ureterocele, periurethral fibrosis, vaginal leomyoma, urethral or vaginal neoplasm should be considered in differential diagnosis. The patient may have irritative symptoms (urinary urgency, frequent and painful urination), obstructive voiding symptoms or urinary incontinence. Physical examination is extremely important in diagnosis. Complete removal of the cyst is an effective treatment method, the risk of recurrence is low. We present a 13-year-old girl with an interlabial ovoid mass with perineal pain. Physical examination revealed normal except for a 3*3 cm cystic formation in the vestibulum. There was no urinary obstruction associated. There was unremarkable in her history. No additional pathology was found in the abdominal and urinary ultrasonograhy. Urethral catheterisation was performed under anaesthesia had identified the urethral opening location, and displacement of the meatus was observed to be on the left lateral wall of the mass ( Fig. 1 ). Paraurethral cyst was totally excised ( Fig. 2 ).

UTERINE CERVICAL CANCER AND HEMODALYSIS

SUMMARY: cervical cancer in Ecuador is a very frequent pathology among lower class and illiterate women,the little access to health services has caused them to arrive late for cancer treatment, so much so that they present with significant vaginal bleeding and masses tumors greater than 10cm in diameter with significant intake of parametria and therefore kidney failure,the reason for the following review is to determine the benefit of dialysis treatment in patients with locally advanced cervical cancer.

Primary vaginal sarcoma treated with upfront fertility-sparing surgery

A 31-year-old nulliparous woman was referred for a 5 cm vaginal tumor diagnosed by physical examnation. She complained of post-coital bleeding in the prior 2 months. Pelvic examination showed a...

Gynecologic Malignancies in Children and Adolescents: How Common is the Uncommon?

The aim of this study is to assess the projected incidence and prognostic indicators of gynecologic malignancies in the pediatric population. In this population-based retrospective cohort study, girls ≤18 years with ovarian, uterine, cervical, vaginal and vulvar malignancies diagnosed between 2000 and 2016 were identified from the Surveillance, Epidemiology and End Results (SEER)-18 registry. The Kaplan–Meier method was used to analyze overall survival (OS). The age-adjusted annual incidence of gynecologic malignancies was 6.7 per 1,000,000 females, with neoplasms of the ovary accounting for 87.5%, vagina 4.5%, cervix 3.9%, uterus 2.5% and vulva 1.6% of all gynecologic malignancies. Malignant germ-cell tumors represented the most common ovarian neoplasm, with an increased incidence in children from 5–18 years. Although certain subtypes were associated with advanced disease stages, the 10-year OS rate was 96.0%. Sarcomas accounted for the majority of vaginal, cervical, uterine and vulvar malignancies. The majority of vaginal neoplasms were observed in girls between 0–4 years, and the 10-year OS rate was 86.1%. Overall, gynecologic malignancies accounted for 4.2% of all malignancies in girls aged 0–18 years and the histologic subtypes and prognosis differed significantly from patients in older age groups.

Pembrolizumab in vaginal and vulvar squamous cell carcinoma: a case series from a phase II basket trial

Vaginal and vulvar squamous cell carcinoma (SCC) are rare tumors that can be challenging to treat in the recurrent or metastatic setting. We present a case series of patients with vaginal or vulvar SCC who were treated with single-agent pembrolizumab as part of a phase II basket clinical trial to evaluate efficacy and safety. Two cases of recurrent and metastatic vaginal SCC, with multiple prior lines of systemic chemotherapy and radiation, received pembrolizumab. One patient had significant reduction (81%) in target tumor lesions prior to treatment discontinuation at cycle 10 following confirmed progression of disease with new metastatic lesions (stable disease by irRECIST criteria). In contrast, the other patient with vaginal SCC discontinued treatment after cycle 3 due to disease progression. Both patients had PD-L1 positive vaginal tumors and tolerated treatment well. One case of recurrent vulvar SCC with multiple surgical resections and prior progression on systemic carboplatin had a 30% reduction in her target tumor lesions following pembrolizumab treatment with a PD-L1 positive tumor. Treatment was discontinued for grade 3 mucositis after cycle 5. Pembrolizumab may provide some clinical benefit to some patients with vaginal or vulvar SCC and is overall safe to utilize in this population. Future studies are needed to evaluate the efficacy of pembrolizumab in these rare tumor types and to identify predictive biomarkers of response.

Laporan Kasus: Fibrosarkoma Vagina Pada Anjing Golden Retriever

A Golden Retriever bitch, 10 years old, came to the Animal Hospital of Brawijaya University, Malang, Indonesia, her conditions was discharge from the vagina, stink smell, polyuria, polydipsia and swelling in the vaginal area that begin to appear one month ago. Physical examination results found her weight 30 kg, scored three for body condition score (scale 1-5), body temperature at 38ºC, pale mucous membrane, and Capillart Reill Time &gt; 2 seconds. Hard mass was palpable in the vaginal area. Based on the anamnesis, physical examination and clinical symptoms, the bitch appeared have some different diagnosis such as pyometra, endometritis, vaginitis, and vaginal tumors. Hematology, radiograph, and histopathological laboratory tests were performed to confirm the diagnosis. Hematologic results showed the bitch suffered from leukocytosis of 41.7 x 103/?L, granulocytosis 36.5 x 103/?L, and hyperchromic microcytic anemia. The results of the radiograph examination showed a radiopaque solid mass in the vagina and uterus. The results of the histopathological examination found there were hyperchromasia nuclei and pleomorphism of fibroblast cell, and formation spindles cell of connective tissue. Based on the results of physical examination, hematological test, radiographic test, and histopathology, the dog was diagnosed with fibrosarcoma in the vagina. The treatment of this case was ovariohysterectomy and removal of the vaginal tumor. Early diagnosis and early treatment largely determine the patient’s prognosis, metastatic vaginal fibrosarcoma tumors showed poor prognosis.

A comparison of the Breslow depth and all-cause survival of male and female genital melanomas

To the Editor: Genital melanomas account for 0.52% of primary melanomas.1 Genital melanomas are more common in women, and vaginal tumors have worse survival than vulvar tumors.1,2 However, differences in Breslow depth among genital tumors has not been fully explored. This study explored differences in Breslow depth and all-cause survival between vulvar, vaginal, penile, and scrotal melanoma.

CT characteristics of uterine and vaginal mesenchymal tumours in dogs.

To describe the CT characteristics of uterine and vaginal mesenchymal tumours in dogs and to discuss imaging findings of the tumour types encountered. Retrospective study on female dogs with confirmed histological diagnosis of uterine and vaginal mesenchymal tumours and available CT images. 120 records obtained through a medical record search were manually evaluated for eligibility, and 11 dogs presenting masses associated with the genital tract were identified. Of these 11 dogs, 7 dogs met the inclusion criteria and were included in the study. A clear degree of overlap was present between measurements of maximal diameter of benign and malignant tumours; however, malignant neoplasms tended to occupy a larger portion of the pelvic canal. Objective measurements of length suggest that malignant tumours were longer than benign forms. Bone involvement was only observed with malignancy. Although CT is likely to play a limited role in the advanced workup of uterine and vaginal mesenchymal neoplasms, CT may represent a more accessible diagnostic tool than MRI and results of this study may help imagers familiarise themselves with their appearances.

Importance of studying primitive neuroectodermal tumors and extraosseous Ewings sarcoma of the vagina and vulva.

Primitive neuroectodermal tumor (PNT) and Ewing's sarcoma are rare, round-cell tumors, characterized by the presence of the t(11; 22)(q24; q12) chromosomal translocation. A review of the literature revealed only 38 previously reported cases of vulvar PNT and Ewing's sarcoma and 15 vaginal PNT and Ewing's sarcoma. Although rare, these types of tumors should be taken into consideration when making a differential diagnosis for vulvar or vaginal tumors. The currently available data is limited, and therefore, case reports are essential for improving knowledge and management of these types of extremely rare tumors. However, further molecular and histopathological studies are essential for an improved understanding of these conditions and for an early, correct diagnosis. Although the gathered and presented data from the present review are limited, the literature demonstrates that the outcome of these types of cancer are more favorable compared with outcomes observed for carcinomas in more typical locations.

Outcomes and dose—volume parameters for computed tomography-based brachytherapy planning for vaginal recurrence of uterine cancer primarily treated with surgery

Background: This study aimed to evaluate the clinical outcomes and dose-volume parameters of computed tomography CT-based brachytherapy for the vaginal recurrence of uterine cancer after hysterectomy. Methods: We evaluated 22 uterine cancer patients treated with CT-based brachytherapy for vaginal recurrence between December 2010 and August 2015. Interstitial brachytherapy (ISBT) was used when the vaginal tumor was thicker than 5 mm and/or located at extended extravaginal tissue, whereas intercavitary brachytherapy was performed if it was 5 mm or thinner. Results: Overall, 11 patients had cervical cancer, and 11 had endometrial cancer. The median pretreatment tumor size on magnetic resonance imaging was 17 mm (range, 0–45 mm). Four patients had vaginal recurrence recognized only in the gynecological examination. The primary location of recurrence was the vagina, with extravaginal extension observed in 9 patients. Seventeen patients (77%) received external beam radiotherapy and brachytherapy. ISBT was performed in 12 patients (55%). The median clinical target volume (CTV) D90 was 69.2 Gy (62.6–72.8 Gy). The median D2cc of the bladder, sigmoid, and rectum were 70.2 (63.8–77.6), 37.4 (30.0–43.6), and 52.8 Gy (38.6–63.5 Gy), respectively. Complete response was reached in all patients. The 5-year overall survival rate and local control rate (LC) were 84.8 and 95.5%, respectively. No patient experienced grade ≥3 complications. Conclusions: CT-based brachytherapy has the potential to become an essential treatment for vaginal recurrences of uterine cancer after hysterectomy as it can achieve good LC without increasing the rate of late complications for selected patients with less recurrences.