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Vaginal Cancer

Updated : February 7, 2024





Background

Vaginal cancer is an uncommon gynecologic cancer. Vaginal cancer is uncommon since most of these lesions are metastasized from another primary location. Most of these metastases originate in other reproductive organs, such as the ovary, cervix, or endometrium.

However, they can also occur in distant areas such as the colon, pancreas, and breast. Similar histological cell types from the cervix and vulva surround the vaginal boundaries. Many disorders that affect the vulva or cervix can also affect the vagina.

Epidemiology

The incidence of vaginal cancer increases with age, with approximately 50% of patients presenting at an age more than 70 years and 20% at an age higher than 80.

Each year, around 3000 females in the United States are diagnosed with vaginal cancer, with approximately 30% succumbing.

Anatomy

Pathophysiology

Persistent HPV infection, particularly with the HPV16 subtype, has been linked to the long-term formation of high squamous intraepithelial lesions and vaginal cancer. Primary melanomas of the female reproductive system are rare and severe malignancies. The vulva is the most common location, followed by the vagina and, less frequently, the cervix.

Tumors involving the vagina and cervix are highly related to high-risk clinicopathologic characteristics such as greater tumor thickness, perforation, positive operative margins, poor clinical prognosis, and lymph node metastases, including mortality from the illness.

Etiology

Malignant and premalignant vaginal lesions are infrequent. The human papillomavirus is a recognized carcinogen for vaginal tumors; however, non-HPV-based carcinogenic mechanisms also exist.

Diethylstilbestrol, a synthesized estrogen administered to pregnant women to avoid miscarriage and premature labor, has previously been linked to vaginal clear cell carcinoma in children. Since regular use was halted in the 1970s, the frequency of this malignancy has reduced.

Several risk factors exist for invasive vaginal cancer as cervical cancer, including tobacco use, younger age at the sexual beginning, HPV, and multiple sexual partnerships.

Genetics

Prognostic Factors

Many prognostic variables have an impact on the management strategy. Lymph node metastasis is a critical prognostic factor. Histology, morphology, and age are other variables.

A recent SEER review of over 2000 patients found that the 5-year cancer survival rate for stage I tumors was 84%, 75% for stage II tumors, and 57% for progressed tumors.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK559126/

Vaginal Cancer

Updated : February 7, 2024




Vaginal cancer is an uncommon gynecologic cancer. Vaginal cancer is uncommon since most of these lesions are metastasized from another primary location. Most of these metastases originate in other reproductive organs, such as the ovary, cervix, or endometrium.

However, they can also occur in distant areas such as the colon, pancreas, and breast. Similar histological cell types from the cervix and vulva surround the vaginal boundaries. Many disorders that affect the vulva or cervix can also affect the vagina.

The incidence of vaginal cancer increases with age, with approximately 50% of patients presenting at an age more than 70 years and 20% at an age higher than 80.

Each year, around 3000 females in the United States are diagnosed with vaginal cancer, with approximately 30% succumbing.

Persistent HPV infection, particularly with the HPV16 subtype, has been linked to the long-term formation of high squamous intraepithelial lesions and vaginal cancer. Primary melanomas of the female reproductive system are rare and severe malignancies. The vulva is the most common location, followed by the vagina and, less frequently, the cervix.

Tumors involving the vagina and cervix are highly related to high-risk clinicopathologic characteristics such as greater tumor thickness, perforation, positive operative margins, poor clinical prognosis, and lymph node metastases, including mortality from the illness.

Malignant and premalignant vaginal lesions are infrequent. The human papillomavirus is a recognized carcinogen for vaginal tumors; however, non-HPV-based carcinogenic mechanisms also exist.

Diethylstilbestrol, a synthesized estrogen administered to pregnant women to avoid miscarriage and premature labor, has previously been linked to vaginal clear cell carcinoma in children. Since regular use was halted in the 1970s, the frequency of this malignancy has reduced.

Several risk factors exist for invasive vaginal cancer as cervical cancer, including tobacco use, younger age at the sexual beginning, HPV, and multiple sexual partnerships.

Many prognostic variables have an impact on the management strategy. Lymph node metastasis is a critical prognostic factor. Histology, morphology, and age are other variables.

A recent SEER review of over 2000 patients found that the 5-year cancer survival rate for stage I tumors was 84%, 75% for stage II tumors, and 57% for progressed tumors.

https://www.ncbi.nlm.nih.gov/books/NBK559126/