FD. presented to a local clinic with complaints of persistent vaginal bleeding, pelvic pain, and a noticeable mass in her vagina. She reported that the symptoms had been present for over six months but had worsened in the past few weeks. She also mentioned experiencing urinary incontinence and a foul-smelling vaginal discharge.

FD. is a 45-year-old woman living in a remote village in northern Nigeria. She has six children and has experienced complications during previous pregnancies, including prolonged labour and limited access to medical care. Her village has no access to modern healthcare facilities, and traditional healers are often the primary source of care.

FD.'s community has limited awareness of gynaecological health, and discussing such issues is often taboo. As a result, FD. delayed seeking help until the symptoms became unbearable. Her family is primarily dependent on subsistence farming, and her husband has discouraged seeking further medical attention due to financial constraints and cultural beliefs.

On examination, a large, ulcerated mass was observed protruding from the vaginal canal. The mass was friable and bled on contact. The patient also had palpable inguinal lymph nodes, indicating possible metastasis.

Due to the limited resources at the local clinic, a referral was made to a regional hospital where an ultrasound and biopsy were performed. The ultrasound revealed a large, irregularly shaped mass involving the vaginal wall, with possible extension to adjacent pelvic structures.

Biopsy confirmed a diagnosis of squamous cell carcinoma of the vagina.

Given the advanced stage of the tumour, treatment options were limited. The regional hospital lacked facilities for radiotherapy, and the nearest centre offering such treatment was over 300 kilometres away. FD. was started on palliative chemotherapy to manage symptoms and was referred to a tertiary care centre for further evaluation. However, due to the distance, cost, and cultural barriers, there was uncertainty about whether she would be able to access the recommended care.

FD.’s condition deteriorated over the following months due to the aggressive nature of the cancer and the lack of comprehensive treatment. Her case highlights the challenges faced by women in sub-Saharan Africa, where late presentation, limited healthcare infrastructure, and socio-cultural barriers significantly impact the prognosis of gynaecological cancers.