Vaginal cancer classification
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Types of vaginal cancer
Types of vaginal cancer, in order of prevalence, include:
- Vaginal squamous cell carcinoma:
- Squamous cell carcinoma accounts for the majority of vaginal cancers.
- The mean age at diagnosis of squamous cell carcinomas is approximately 60 years.
- These tumors may be nodular, ulcerative, indurated, endophytic, or exophytic.
- Vaginal cancer is also associated with the human papillomavirus (HPV).
- Vaginal epithelium is more stable than cervical epithelium, which undergoes constant metaplasia, and is less susceptible to oncogenic viruses.
- Verrucous carcinoma is a less common variant of vaginal squamous cell carcinoma that is well-differentiated and has low malignant potential.
- It usually presents as a large, warty, fungating mass that is locally aggressive but rarely metastasizes.
- Vaginal adenocarcinoma:
- Adenocarcinomas represent as primary vaginal cancers in women younger than 20 years old.
- Adenocarcinomas arise in areas of vaginal adenosis, Wolffian rest elements, periurethral glands.
- Clear cell variants are the best known type of adenocarcinoma.
- Clear cell carcinoma presents in young women who have been exposed in utero to diethylstilbestrol (DES).
- Clear cell carcinomas of the vagina present as polypoid masses,on the anterior wall of the vagina.
- DES exposure can result in both cervical and vaginal clear cell adenocarcinomas.
- The incidence of invasive or in situ squamous cell cancer of the cervix is increased in women exposed to DES in utero.
- It is recommended that women exposed to DES in utero have their first gynecologic examination at menarche.
- Vaginal sarcoma:
- Rhabdomyosarcoma in pediatric population, eg. sarcoma botryoides, Leiomyosarcomas, endometrial stromal sarcomas, malignant mixed müllerian tumors.
- Rhabdomyosarcomas are the major types of primary vaginal sarcomas.
- The most common of these is the embryonal rhabdomyosarcoma (sarcoma botryoides).
- Sarcoma botryoides is highly malignant tumor that occurs in the vagina during infancy and early childhood.
- This sarcoma generally presents as soft nodules that fill and sometimes protrude from the vagina, resembling a bunch of grapes (botryoides comes from the Greek word botrys, which means "grapes")
- Melanomas arising on the vaginal mucosa are rare'
- It mostly originate from mucosal melanocytes in areas of melanosis or from atypical melanocytic hyperplasia.
- The presenting symptom is most commonly vaginal bleeding.
- They appear as a blue-black or black-brown mass, plaque, or ulceration, most frequently on the distal one-third of the anterior vaginal wall.
- They are often nonpigmented.
- Primary malignant melanomas of the urogenital mucous membranes may have aggressive behavior with a high rate of local failure and metastases.
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- DeMatos P, Tyler D, Seigler HF (July 1998). "Mucosal melanoma of the female genitalia: a clinicopathologic study of forty-three cases at Duke University Medical Center". Surgery. 124 (1): 38–48. PMID 9663250.
- Frumovitz M, Etchepareborda M, Sun CC, Soliman PT, Eifel PJ, Levenback CF, Ramirez PT (December 2010). "Primary malignant melanoma of the vagina". Obstet Gynecol. 116 (6): 1358–65. doi:10.1097/AOG.0b013e3181fb8045. PMID 21099603.