Cancer of the vagina

Abstract

Diagnosis of a primary vaginal cancer is rare because most of these lesions will be metastatic from another primary site. Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This will be associated with persistence of high‐risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, similar to cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer.

Radiotherapy Plus Chemotherapy Is Associated With Improved Survival Compared to Radiotherapy Alone in Patients With Primary Vaginal Carcinoma: A Retrospective SEER Study

“…In the subgroup analysis, treatment with RTCT had superior survival compared to treatment with RT alone for patients with SCC and other histological types. However, for those with ADE, the survival difference between the two groups did not reach statistical significance, likely due to the small sample size, although vaginal ADE has been reported to have a higher incidence of local recurrence and frequently metastasizes to the lung and supraclavicular and pelvic nodes (14,16,28,29). Studies with larger size are warranted to address this.…”

Diffuse large B-cell lymphoma of the vagina in pregnancy

“…Vaginal cancers are very rare with the American Cancer Society estimating that only 1 in every 1100 women will develop vaginal cancer in their lifetime 6. Squamous cell carcinoma is the most common histological type, while primary lymphoma of the vagina is rare 7. DLBCL is the most common vaginal lymphoma while Burkitt’s lymphoma was even more rare 3 8–11.…”

“…In some cases with absent B symptoms (fever, weight loss, drenching night sweats) and considering the rarity of vaginal lymphoma, initial imaging findings may be misdiagnosed as squamous cell carcinoma 10. Other differentials include adenocarcinoma, melanoma, sarcoma and carcinoid, and these are usually metastatic from regional structures such as the cervix, bladder, ovary, vulva, rectum or uterus 7. On tissue analysis, DLBCL typically has an effaced architecture with large cells that resemble immunoblasts or centroblasts.…”

Female Lower Genital Tract Cancer Prevention

“…For stage IB3, IIA2, and IIB-IVB, concurrent chemoradiation therapy has been standard treatment since 1999. 16 After a biopsy reveals invasive cancer of vagina, pelvic and/or radiologic (if available) examinations must be done to support clinical data for staging process. If it is in the vaginal wall only without paracolpial involvement, the case should be allotted to stage I.…”