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{{Vaginal cancer}}
{{Vaginal cancer}}
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==Overview==
==Overview==
Vaginal cancer may be classified according to histopathology into [[squamous cell carcinoma]], [[adenocarcinoma]], vaginal [[germ cell tumor]], and vaginal sarcoma.  
[[Vaginal cancer]] may be classified according to histopathology into [[squamous cell carcinoma]], [[adenocarcinoma]], [[vaginal sarcoma]] and [[melanoma]].
 


==Types of vaginal cancer==
==Types of vaginal cancer==
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Types of vaginal cancer, in order of prevalence, include:
Types of vaginal cancer, in order of prevalence, include:


* '''Vaginal [[squamous cell carcinoma]]: '''
* '''Vaginal squamous cell carcinoma: '''
:* Arises from the thin, flat [[squamous cell]]s that line the vagina. By far, the commonest accounts for 80-85% of primary vaginal malignancies, and presents in older individuals.
:*[[Squamous cell carcinoma]] accounts for the majority of [[vaginal cancers]].
 
:*The mean age at diagnosis of [[squamous cell carcinomas]] is approximately 60 years.<ref name="pmid9731908">{{cite journal |vauthors=Creasman WT, Phillips JL, Menck HR |title=The National Cancer Data Base report on cancer of the vagina |journal=Cancer |volume=83 |issue=5 |pages=1033–40 |date=September 1998 |pmid=9731908 |doi= |url=}}</ref>
* '''Vaginal [[adenocarcinoma]]: '''
:*These [[tumors]] may be [[nodular]], [[ulcerative]], indurated, endophytic, or exophytic.
:* ~15% second commonest subtype, presents in younger individuals and arising from the glandular (secretory) cells in the lining of the vagina that produce some vaginal fluids. Adenocarcinoma is more likely than squamous cell cancer to spread to the [[lung]]s and [[lymph node]]s. It is found most often in women aged 30 or younger, and has been found in a small percent of women whose mothers in the 1950s used [[diethylstilbestrol]] to prevent threatened abortions.
:*[[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]]<ref name="pmid2166263">{{cite journal |vauthors=Ikenberg H, Runge M, Göppinger A, Pfleiderer A |title=Human papillomavirus DNA in invasive carcinoma of the vagina |journal=Obstet Gynecol |volume=76 |issue=3 Pt 1 |pages=432–8 |date=September 1990 |pmid=2166263 |doi= |url=}}</ref>.
::* Clear cell carcinoma of the vagina: rare, previous [[diethylstilbestrol]] (DES) exposure
:*[[Verrucous]] [[carcinoma]] is a less common variant of [[vaginal]] [[squamous cell carcinoma]] that is well-differentiated and has low [[malignant]] potential<ref name="pmid964693">{{cite journal |vauthors=Isaacs JH |title=Verrucous carcinoma of the female genital tract |journal=Gynecol. Oncol. |volume=4 |issue=3 |pages=259–69 |date=September 1976 |pmid=964693 |doi= |url=}}</ref>.
 
:*It usually presents as a large, [[warty]], fungating mass that is locally aggressive but rarely [[metastasizes]].
* '''Vaginal [[germ cell tumor]]s: '''
* '''Vaginal adenocarcinoma: '''
:* They are rare (primarily [[teratoma]] and [[endodermal sinus tumor]]), and present most often in infants and children.
:*[[Adenocarcinomas]] represent as primary [[vaginal cancers]] in women younger than 20 years old<ref name="pmid9731908">{{cite journal |vauthors=Creasman WT, Phillips JL, Menck HR |title=The National Cancer Data Base report on cancer of the vagina |journal=Cancer |volume=83 |issue=5 |pages=1033–40 |date=September 1998 |pmid=9731908 |doi= |url=}}</ref>.
:*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]])<ref name="pmid5549830">{{cite journal |vauthors=Herbst AL, Ulfelder H, Poskanzer DC |title=Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women |journal=N. Engl. J. Med. |volume=284 |issue=15 |pages=878–81 |date=April 1971 |pmid=5549830 |doi=10.1056/NEJM197104222841604 |url=}}</ref>.  
:*[[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]]<ref name="pmid2004313">{{cite journal |vauthors=Hanselaar AG, Van Leusen ND, De Wilde PC, Vooijs GP |title=Clear cell adenocarcinoma of the vagina and cervix. A report of the Central Netherlands Registry with emphasis on early detection and prognosis |journal=Cancer |volume=67 |issue=7 |pages=1971–8 |date=April 1991 |pmid=2004313 |doi= |url=}}</ref>.
:*The [[incidence]] of invasive or in situ [[squamous cell cancer]] of the [[cervix]] is increased in women exposed to [[DES]] in utero<ref name="pmid10866558">{{cite journal |vauthors=Verloop J, Rookus MA, van Leeuwen FE |title=Prevalence of gynecologic cancer in women exposed to diethylstilbestrol in utero |journal=N. Engl. J. Med. |volume=342 |issue=24 |pages=1838–9 |date=June 2000 |pmid=10866558 |doi=10.1056/NEJM200006153422415 |url=}}</ref>.
:*It is recommended that women exposed to [[DES]] in utero have their first [[gynecologic]] examination at [[menarche]].


* '''Vaginal sarcoma: '''
* '''Vaginal sarcoma: '''
:* [[rhabdomyosarcoma]] in paediatric population, eg. [[Sarcoma botryoides]]
:* [[Rhabdomyosarcoma]] in pediatric population, eg. [[sarcoma botryoides]], [[Leiomyosarcomas]], [[endometrial stromal sarcomas]], [[malignant mixed müllerian tumors]].
:*[[Rhabdomyosarcomas]] are the major types of primary [[vaginal sarcomas]]<ref name="pmid4915719">{{cite journal |vauthors=Hilgers RD, Malkasian GD, Soule EH |title=Embryonal rhabdomyosarcoma (botryoid type) of the vagina. A clinicopathologic review |journal=Am. J. Obstet. Gynecol. |volume=107 |issue=3 |pages=484–502 |date=June 1970 |pmid=4915719 |doi= |url=}}</ref>.
:*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")
'''Melanoma: '''
:*[[Melanomas]] arising on the [[vaginal mucosa]] are rare'
:*It mostly originate from [[mucosal]] [[melanocytes]] in areas of [[melanosis]] or from atypical [[melanocytic]] [[hyperplasia]]<ref name="pmid9663250">{{cite journal |vauthors=DeMatos P, Tyler D, Seigler HF |title=Mucosal melanoma of the female genitalia: a clinicopathologic study of forty-three cases at Duke University Medical Center |journal=Surgery |volume=124 |issue=1 |pages=38–48 |date=July 1998 |pmid=9663250 |doi= |url=}}</ref>.
:*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<ref name="pmid21099603">{{cite journal |vauthors=Frumovitz M, Etchepareborda M, Sun CC, Soliman PT, Eifel PJ, Levenback CF, Ramirez PT |title=Primary malignant melanoma of the vagina |journal=Obstet Gynecol |volume=116 |issue=6 |pages=1358–65 |date=December 2010 |pmid=21099603 |doi=10.1097/AOG.0b013e3181fb8045 |url=}}</ref>.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 13:11, 5 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]

Overview

Vaginal cancer may be classified according to histopathology into squamous cell carcinoma, adenocarcinoma, vaginal sarcoma and melanoma.

Types of vaginal cancer

Types of vaginal cancer, in order of prevalence, include:

  • Vaginal squamous cell carcinoma:
  • Vaginal adenocarcinoma:
  • Vaginal sarcoma:

Melanoma:

References

  1. 1.0 1.1 Creasman WT, Phillips JL, Menck HR (September 1998). "The National Cancer Data Base report on cancer of the vagina". Cancer. 83 (5): 1033–40. PMID 9731908.
  2. Ikenberg H, Runge M, Göppinger A, Pfleiderer A (September 1990). "Human papillomavirus DNA in invasive carcinoma of the vagina". Obstet Gynecol. 76 (3 Pt 1): 432–8. PMID 2166263.
  3. Isaacs JH (September 1976). "Verrucous carcinoma of the female genital tract". Gynecol. Oncol. 4 (3): 259–69. PMID 964693.
  4. Herbst AL, Ulfelder H, Poskanzer DC (April 1971). "Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women". N. Engl. J. Med. 284 (15): 878–81. doi:10.1056/NEJM197104222841604. PMID 5549830.
  5. Hanselaar AG, Van Leusen ND, De Wilde PC, Vooijs GP (April 1991). "Clear cell adenocarcinoma of the vagina and cervix. A report of the Central Netherlands Registry with emphasis on early detection and prognosis". Cancer. 67 (7): 1971–8. PMID 2004313.
  6. Verloop J, Rookus MA, van Leeuwen FE (June 2000). "Prevalence of gynecologic cancer in women exposed to diethylstilbestrol in utero". N. Engl. J. Med. 342 (24): 1838–9. doi:10.1056/NEJM200006153422415. PMID 10866558.
  7. Hilgers RD, Malkasian GD, Soule EH (June 1970). "Embryonal rhabdomyosarcoma (botryoid type) of the vagina. A clinicopathologic review". Am. J. Obstet. Gynecol. 107 (3): 484–502. PMID 4915719.
  8. 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.
  9. 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.