Vaginal cancer

Notes
  • Majority (≥ 95%) are squamous cell carcinoma;
  • Statistics: It is a rare cancer contributing only 1% of gynecologic cancers.
Symptoms
  • Asymptomatic (occasionally)
  • Dyspareunia
  • Postmenopausal, postcoital, or intermenstrual abnormal vaginal bleeding
  • Rectovaginal fistulas (mainly advanced cancer)
  • Vesicovaginal fistulas (mainly advanced cancer)
  • Watery vaginal discharge
Diagnosis
  • Physical examination
  • Punch biopsy or wide local excision and histology and staging
  • Colposcopy
  • Cystoscopy (to examine bladder)
  • Proctoscopy (to examine the anal cavity, rectum, or sigmoid colon)
  • Chest x-ray (for possible pulmonary metastasis)
  • CT scan
  • MRI
Differential
  • Cervical cancer
  • Vulvar cancer
  • Ovarian cancer
  • Rectal carcinoma
  • Uterine carcinoma
  • Vaginal lymphoma
Prevention
  • Prevention of HPV infection
  • Avoiding smoking
  • Avoiding exposure to Diethylstilbestrol
  • Treatment of cervical cancer
  • Practicing safe sex
Management
  • Hysterectomy plus vaginectomy
  • Lymph node dissection
  • Chemotherapy is known to be curative for advanced vaginal cancer, and there are no standard drug regimens
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