Makindo Medical Notes.com

Related Subjects: |Causes of abnormal Vaginal bleeding |Vaginal Carcinoma |Cervical cancer |Antepartum haemorrhage |Trauma: Traumatic Brain Head Injury (TBI) |Post Menopausal Bleeding |Postpartum haemorrhage

Vaginal carcinoma is a rare type of cancer that originates in the cells lining the vagina. It represents about 1-2% of all gynecologic malignancies. Vaginal cancer is more common in older women and can develop in different types of cells within the vagina, leading to various histological subtypes, with squamous cell carcinoma being the most common.

Aetiology

• Usually squamous in upper 1/3rd of vagina
• Associated with the human papillomavirus.

Pathology

• Premalignant vagina: intraepithelial neoplasia (abbreviated as VAIN)
• Squamous cell cancer (squamous carcinoma) 90%
• Adenocarcinoma 5% - Clear cell adenocarcinoma seen with previous exposure to diethylstilbestrol when less than 18 weeks gestation in utero
• Malignant melanomas, Sarcomas

Clinical

• PV Bleeding and discharge
• Dyspareunia (Pain During Intercourse)
• Vaginal mass, dysuria, frequency
• local and lymphatic spread
• Changes in Bowel Habits: e.g. If the cancer invades the rectum

Investigations

• Pelvic Examination
• Biopsy of lesion
• Colposcopy and biopsy
• Imaging Studies: CT scans, MRI, or PET scans

Vaginal carcinoma is a rare but serious cancer that requires early detection and treatment to improve outcomes. Risk factors include HPV infection, DES exposure, and a history of cervical cancer. Treatment typically involves surgery, radiation therapy, and sometimes chaemotherapy, depending on the stage and type of cancer. Regular gynecological exams and awareness of symptoms are crucial for early diagnosis and management.

Management

• Surgery: depends on the stage and location of the tumour. Local excision, partial or total vaginectomy (removal of the vagina), or pelvic exenteration for advanced cases.
• Radiotherapy for women who cannot undergo surgery.
• Chemotherapy: May be used in combination