How would you treat a p16+ squamous cell carcinoma confined in the recto-vaginal septum with no suspicious adenopathy on PET or MRI?   

Early vaginal or anal cancer still has relatively high rates of lymph node involvement. In vaginal cancer, T1 lesions have lymph node involvement rates of 5 - 15%. In anal cancer, T1 lesions have a higher rate of 5 - 50%. If there are no mucosal changes then it is possible this is an in-transit LN f...

I would favor chemo-radiation for this rare entity, using cisplatinum as a radiation sensitizer as we do for cervical cancer with weekly 40 mg/m2. External radiation should cover the internal and external iliac lymph nodes plus common iliac to 45 Gy/25 fractions. In the case of any involved nodes on...

We have a handful of patients with similar presentations in my practice. A thorough MCC discussion and radiological review to address likely primary should be undertaken prior to deciding on the treatment pathway. If this is considered to be HPV-associated anal cancer, then the patient would benefi...

Definitive concurrent chemo RT. Pelvic nodes with consideration for some mesorectum nodal reaching around primary to 45 Gy. IMRT boost to primary around 70 Gy based on oar dose. 

Wondering if cancer type ID or similar testing would be of any help here.

Need to determine whether this is a cancer of mullerian (gynecological) origin or gastrointestinal origin. Biopsies should be evaluable for IHC to differentiate between gynecological markers. If an exact diagnosis was not obtained from the pathologists at either your or the local academic center, wo...