Malignant Vaginal Tumor

Malignant vaginal tumors are usually secondary: direct extension from cervical cancer, or from endometrial/ovarian/choriocarcinoma; bladder/urethral/rectal cancer also metastasize to vagina. Primary vaginal malignancy is very rare, ~1% of female genital malignancies. Mostly squamous cell carcinoma, choriocarcinoma; adenocarcinoma/sarcoma/malignant melanoma even rarer. Secondary cancer is more common; exclude secondary disease before diagnosing primary. Early: asymptomatic or only increased discharge + contact bleeding. Later: enlarging necrotic lesion, foul discharge, painless vaginal bleeding; local extension causes organ-specific symptoms.

Common Symptoms

Dyschezia; increased vaginal discharge; rectal pain; tenesmus; constipation; anal tenesmus

Causes and Pathogenesis

Etiology: HPV related to vaginal intraepithelial neoplasia (VAIN) leading to invasive cancer, but exact risk unclear. Clear-cell adenocarcinoma in young women linked to maternal DES exposure (1/1000, highest risk in first 12 weeks). Pathology: primary vaginal cancer most often at posterior fornix (chronic irritation). Three macroscopic types: (1) cauliflower (exophytic, upper posterior wall, well-differentiated); (2) infiltrative/ulcerative (anterior wall, rapid spread); (3) mucosal (slow, mucosal layer, in situ). Histology: nearly all squamous cell, rare adenocarcinoma.

Treatment

Drug, supportive therapy

Preventive Measures

Early disease asymptomatic or only discharge/contact bleeding; regular checkups. Treat leukoplakia/chronic inflammation/ulcers. Irregular bleeding/abnormal discharge: early diagnosis/treatment.

Department to Visit

It is recommended to visit the Surgical Oncology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.