Vaginal cancer differential diagnosis: Difference between revisions

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*[[Dysmenorrhea]]
*[[Dysmenorrhea]]
*[[Dyspareunia]]  
*[[Dyspareunia]]  
*Vaginal bleeding after intercourse, between periods or after menopause
*Vaginal bleeding after intercourse.
*Watery, bloody vaginal discharge that may be heavy and have a foul odor
*Watery, bloody vaginal discharge,foul odor
|
|
* Endophytic enlarged, indurated cervix whose surface is smooth, referred to as a "barrel shaped cervix."
* Endophytic enlarged, indurated cervix whose surface is smooth, "barrel shaped cervix."
*Adnexal masses
*Adnexal masses
*superficial ulceration, exophytic tumor in the exocervix, or infiltration of the endocervix
*superficial ulceration, exophytic tumor in the exocervix, or infiltration of the endocervix

Revision as of 15:54, 16 January 2019

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

Overview

Vaginal cancer must be differentiated from cervical carcinoma, rectal carcinoma, uterine carcinoma, vaginal lymphoma, vaginal cyst, vaginal node of endometriosis, and uterine fibroids.

Differential diagnosis

For large lesions consider invasion of the vagina by:

Malignant involvement of the vagina from metastatic spread is much more common, and except for isolated reports of metastases from extragenital cancers, the most common cause of metastatic disease is direct local invasion from the female urogenital tract. Therefore some authors state the diagnosis of primary vaginal carcinoma should be diagnosed only if other gynecologic malignancies have been excluded.

Other differential considerations include:

Diseases with similar symptoms (bleeding or vaginal discharge) are the following:

Clinical Features Physical Examination Diagnostic Findings
Cervical Carcinoma
  • Endophytic enlarged, indurated cervix whose surface is smooth, "barrel shaped cervix."
  • Adnexal masses
  • superficial ulceration, exophytic tumor in the exocervix, or infiltration of the endocervix
  • Lateral displacement of the cervix
  • Increased serum cancer antigen-125 
  • Nodules of the recto vaginal septum and hypoechoic, vascular mass on MRI
  • Laproscopic visualization confirms the diagnosis
Rectal Carcinoma[1]
  • Diffuse uterine enlargement always less than size corresponding to less than 12 weeks of gestation
Submucous uterine leiomyomas[2]
  • Mobile uterus with an irregular contour
Uterine Carcinoma
  • Increased serum cancer antigen-125 
  • Nodules of the recto vaginal septum and hypoechoic, vascular mass on MRI
  • Laproscopic visualization confirms the diagnosis
Vaginal Lymphoma
  • Increased serum cancer antigen-125 
  • Nodules of the recto vaginal septum and hypoechoic, vascular mass on MRI
  • Laproscopic visualization confirms the diagnosis
Endometriosis
  • Increased serum cancer antigen-125 
  • Nodules of the recto vaginal septum and hypoechoic, vascular mass on MRI
  • Laproscopic visualization confirms the diagnosis
Adenomyosis
  • Increased serum cancer antigen-125 
  • Nodules of the recto vaginal septum and hypoechoic, vascular mass on MRI
  • Laproscopic visualization confirms the diagnosis
  1. Parker JD, Leondires M, Sinaii N, Premkumar A, Nieman LK, Stratton P (2006). "Persistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis". Fertil Steril. 86 (3): 711–5. doi:10.1016/j.fertnstert.2006.01.030. PMID 16782099.
  2. Donnez J, Donnez O, Matule D, Ahrendt HJ, Hudecek R, Zatik J; et al. (2016). "Long-term medical management of uterine fibroids with ulipristal acetate". Fertil Steril. 105 (1): 165–173.e4. doi:10.1016/j.fertnstert.2015.09.032. PMID 26477496.