Transgender Health: A Case of Vulvar Cancer After Gender Reassignment

What is it about?

This case report describes the challenging diagnosis of a gender incongruent tumor in a transgender patient. The patient presented with a suspected local infection of the neoscrotum and was initially treated with antibiotics and placement of a suprapubic catheter. The diagnosis of a squamous cell carcinoma (SCC) of the vulva was made after several unsuccessful treatment attempts. The tumor was discovered incidentally during an elective procedure scheduled for urethrocutaneous fistula repair. The patient had a history of gender-affirming surgery, which included parts of the vulva being used to create the neoscrotum. The diagnosis of SCC of the vulva is rare and has not been previously reported in a transgender male. The report aims to increase awareness among healthcare providers about the importance of timely and effective early cancer detection and care for transgender patients, who have been marginalized in the medical field for many years. The report also emphasizes the need for standardized screening methods, reference guidelines, and education of healthcare providers to provide comprehensive care to transgender patients.

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Why is it important?

This case report is important for several reasons. Firstly, it highlights the importance of provider knowledge about transgender health and the necessity for transgender patients to access timely and effective early cancer detection and care. The case illustrates a real-world experience of a complex presentation of a rare tumour in a transgender patient, which emphasizes the need for healthcare providers to be aware of the potential complications and pitfalls of gender-affirming surgery (GAS) and postoperative care. Secondly, the case report underscores the fact that transgender patients remain susceptible to tumours of the biological sex even after removal of the internal genitalia, highlighting the importance of continued cancer screening and prevention for these patients. This is particularly important given the increasing rate of GAS and the likelihood that general urologists will become more involved in gender-affirming care. Finally, the case report emphasizes the need for the development of standardized screening methods, reference guidelines, and education of healthcare providers to provide comprehensive care to transgender patients. More data, including further studies and case reports, are needed to allow early access for detection and effective therapy. Key Takeaways: 1. Provider knowledge about transgender health and timely cancer detection and care is essential for transgender patients. 2. Transgender patients remain susceptible to tumours of the biological sex even after removal of the internal genitalia, highlighting the need for continued cancer screening and prevention. 3. The development of standardized screening methods, reference guidelines, and education of healthcare providers is necessary to provide comprehensive care to transgender patients.