Abstract
The vagina is a muscular part of the female genital tract, and it extends from the vulva to the cervix. Its length is approximately 7.5 cm, and anatomically, it is found between the bladder and the rectum. The wall of the vagina has three layers: mucosa, muscularis and adventitia. The mucosa is formed by squamous epithelium [Nikolaou M. Vaginal cancer, international manual of oncology practice. Springer, Cham. https://doi.org/10.1007/978-3-319-21683-6_20, 2015]. The upper third of the vagina is the part in which cancer is most common (56%), secondarily the lower third (31%) and lastly the middle third (13%) [Slomovitz BM, Coleman RL. Invasive cancer of the vagina. In: DiSaia PJ, Creasman WT (eds) Clinical gynecologic oncology, 8th edn. Elsevier Saunders, Philadelphia, pp 245–259, 2012]. The upper two-thirds of the vagina drain mainly into the pelvic lymph nodes, in contrast with the lower third that drains into the inguinal lymph nodes. This knowledge helps in understanding the mechanism of metastasis and the choice of the best treatment in a given case [Monaghan JM. Invasive tumor of vagina: clinical features and management. In: Coppleson M (ed) Gynecologic oncology. Churchill Livingstone, Edinburgh, p 506, 1992].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Nikolaou M (2015) Vaginal cancer, international manual of oncology practice. Springer, Cham. https://doi.org/10.1007/978-3-319-21683-6_20
Slomovitz BM, Coleman RL (2012) Invasive cancer of the vagina. In: DiSaia PJ, Creasman WT (eds) Clinical gynecologic oncology, 8th edn. Elsevier Saunders, Philadelphia, pp 245–259
Monaghan JM (1992) Invasive tumor of vagina: clinical features and management. In: Coppleson M (ed) Gynecologic oncology. Churchill Livingstone, Edinburgh, p 506
Creasman WT, Phillips JL, Menck HR (1998) The national cancer database report on cancer of the vagina. Cancer 83(5):1033–1040
Garland SM, Joura EA, Ault KA et al (2018) Human papillomavirus genotypes from vaginal and vulvar intraepithelial neoplasia in females 15–26 years of age. Obstet Gynecol 132(2):261–270. https://doi.org/10.1097/AOG.0000000000002736
Daling JR, Madeleine MM, Schwartz SM et al (2002) A population – based study of squamous cell vaginal cancer: HPV and cofactors. Gynecol Oncol 84(2):263–270
Brinton LA, Nasca PC, Mallin K et al (1990) Case – control study of in situ and invasive carcinoma of the vagina. Gynecol Oncol 38(1):49–54
Perez CA, Camel HM, Galakatos AE et al (1988) Definitive irradiation in carcinoma of the vagina: long-term evaluation and results. Int J Radiat Oncol Biol Phys 15:1283–1290
Andersen ES (1989) Primary carcinoma of the vagina: a study of 29 cases. Gynecol Oncol 33(3):317–320
Ball HG, Berman ML (1982) Management of primary vaginal carcinoma. Gynecol Oncol 14(2):154–163
Chyle V, Zagars GK, Wheeler JA et al (1996) Definitive radiotherapy for carcinoma of the vagina: outcome and prognostic factors. Int J Radiat Oncol Biol Phys 35(5):891–905
Gallup DG, Talledo OE, Shah KJ et al (1987) Invasive squamous cell carcinoma of the vagina: a 14-year study. Obstet Gynecol 69(5):782–785
Kirkbride P, Fyles A, Rawilings GA et al (1995) Carcinoma of the vagina – experience at the Princess Margaret Hospital (1974–1989). Gynecol Oncol 56(3):435–443
Lenechan PM, Meffe F, Lickrish GM (1986) Vaginal intraepithelial neoplasia: biologic aspects and management. Obstet Gynecol 68(3):333–337
Leung S, Sexton M (1993) Radical radiation therapy for carcinoma of the vagina – impact of treatment modalities on outcome: peter maccallum cancer institute experience 1970–1990. Int J Radiat Oncol Biol Phys 25(3):413–418
Spirtos NM, Doshi DS et al (1989) Radiation therapy for primary squamous cell carcinoma of the vagina: Stanford University experience. Gynecol Oncol 35(1):20–26
Stock RG, Chen AS, Seski J (1995) A 30-year experience in the management of primary carcinoma of the vagina: analysis of prognostic factors and treatment modalities. Gynecol Oncol 56(1):45–52
Stock RG, Mychalczak B, Armstrong JG et al (1992) The importance of brachytherapy technique in the management of primary carcinoma of the vagina. Int J Radiat Oncol Biol Phys 24(4):747–753
Urbanski K, Kojis Z, Reinfuss M et al (1996) Primary invasive vaginal carcinoma treated with radiotherapy: analysis of prognostic factors. Gynecol Oncol 60(1):16–21
Goodman A, Schorge J, Greene M (2011) The long – term effects or in utero exposures – the DES story. N Engl J Med 364:2028–2084
Edge S, Byrd D, Compton C et al (2010) AJCC Cancer staging manual. Springer, New York
FIGO Committee on Gynecologic Oncology (2009) Current FIGO staging for cancer of the vagina, fallopian tube, ovary, and gestational trophoblastic neoplasia. Int J Gynaecol Obstet 105(1):3–4
Zaino R, Nucci M, Kurman R (2011) Disease of the vagina. In: Ellenson L, Kurman R, Ronnett B (eds) Blaustein’s pathology of the female genital tract, 6th edn. Springer, New York, pp 105–154
Brunner A, Grimm C, Polterauer S et al (2011) The prognostic value of human papillomavirus in patients with vaginal cancer. Int J Gynecol Cancer 21:923–929
Fuste V, del Pino M, Perez A et al (2010) Primary squamous cell carcinoma of the vagina: human papillomavirus detection, p16INK4A overexpression and clinicopathological correlations. Histopathology 57:907–916
Creasman WT, Phillips JL, Menck HR (1998) The national cancer data base report on cancer of the vagina. Cancer 83:1033–1040
Kurman R, Ronnett B, Sherman M et al (2010) Tumors of the cervix, vagina and vulva, vol 13. ARP Press, Washington, DC
Frank S, Deavers M, Jhingran A et al (2007) Primary adenocarcinoma of the vagina not associated with diethylstilbestrol (DES) exposure. Gynecol Oncol 105:470–474
Gardner G, Reidy-Lgunes D, Gehrig P (2011) Neuroendocrine tumors of the gynecologic track: a Society of Gynecologic Oncology (SGO) clinical document. Gynecol Oncol 122:190–198
Akl M, Naidu S, McCullough A et al (2010) Vaginal paraganglioma presenting as a pelvic mass. Surgery 147:169–171
Sedenik M, Yan Z, Khalbuss W et al (2007) Malignant mixed mullerian tumor of the vagina: case report with review of literature, immunohistochemical study, and evaluation for human papillomavirus. Hum Pathol 38:1282–1288
Lee H, Jang K, Park H et al (2008) Angiomyofibroblastoma of the vagina in a breast cancer patients. Pathology (Phila) 40(5):534–536
Margo G, Caltabiano R, Kacerovska D et al (2012) Vulvovaginal myofi broblastoma: expanding the morphological and immunohistochemical spectrum: a clinopathologic study of 10 cases. Hum Pathol 43:243–253
Terenziani M, Spreafi co F, Collini P et al (2007) Endodermal sinus tumor of the vagina. Pegiatr Bloob Cancer 48:577–578
Gangopadhyay M, Raha K, Sinha S et al (2009) Endodermal sinus tumor of the vagina in children: a report of two cases. Indian J Pathol Microbiol 52:403–404
Lagoo A, Robboy SJ (2005) Lymphoma of the female genital tract: current status. Int J Gynecol Pathol 25:1–21
Berchuck A, Rodriguez G, Kamel A et al (1990) Expression of epidermal growth factor receptor and HER-2/neu in normal and neoplastic cervix, vulva, and vagina. Obstet Gynecol 76(3 Pt.1):381–387
Pingley S, Shrivastava SK, Sarin R et al (2000) Primary carcinoma of the vagina: tata memorial hospital experience. Int J Radiat Oncol Biol Phys 46(1):101–108
Cheng D, Ng TY, Ngan HY et al (1999) Wide local excision (WLE) for vaginal intraepithelial neoplasia (VAIN). Acta Obstet Gynecol Scand 78:648–652
Dodge JA, Eltabbakh GH, Mount SL et al (2001) Clinical features and risk of recurrence among patients with vaginal intraepithelial neoplasia. Gynecol Oncol 83:363–369
Hacker NF, Eifel PJ, van der Velden J (2012) Cancer of the vagina. Int J Gynaecol Obstet 119(Suppl 2):S97–S99
Chyle V, Zagars GK, Wheeler JA et al (1996) Definitive radiotherapy for carcinoma of the vagina: outcome and prognostic factors. Int J Radiat Oncol Biol Phys 35:891–905
de Crevoisier R, Sanfilippo N, Gerbaulet A et al (2007) Exclusive radiotherapy for primary squamous cell carcinoma of the vagina. Radiother Oncol 85:362–370
Frank SJ, Jhingran A, Levenback C (2005) Definitive radiation therapy for squamous cell carcinoma of the vagina. Int J Radiat Oncol Biol Phys 62:138–147
Kirkbride P, Fyles A, Rawlings GA et al (1995) Carcinoma of the vagina−experience at the Princess Margaret Hospital (1974–1989). Gynecol Oncol 56:435–443
Kucera H, Mock U, Knocke TH (2001) Radiotherapy alone for invasive vaginal cancer: outcome with intracavitary high dose rate brachytherapy versus conventional low dose rate brachytherapy. Acta Obstet Gynecol Scand 80:355–360
Moran MS, Castrucci WA, Ahmad M et al (2010) Clinical utility of the modified segmental boost technique for treatment of the pelvis and inguinal nodes. Int J Radiat Oncol Biol Phys 76:1026–1036
Boronow RC, Hickman BT, Reagan MT et al (1987) Combined therapy as an alternative to exenteration for locally advanced vulvovaginal cancer. II. Results, complications and dosimetric and surgical considerations. Am J Clin Oncol 10(2):171–181
Tjalma WA, Monaghan JM, de Barros Lopes A et al (2001) The role of surgery in invasive squamous carcinoma of the vagina. Gynecol Oncol 81(3):360–365
Hatch KD (2006) A3. Vaginal intraepithelial neoplasia (VAIN). Int J Gyncol Obstet 94:S40–S43
Perez CA, Korba A, Sharma S (1977) Dosimetric considerations in irradiation of carcinoma of the vagina. Int J Radiat Oncol Biol Phys 2(7–8):639–649
Perez CA, Grigsby PW, Garipagaoglu M et al (1999) Factors affecting long – term outcome of irradiation in carcinoma of the vagina. Int J Radiat Oncol Biol Phys 44(1):37–45
Roberts WS, Hoffman MS, Kavanagh JJ et al (1991) Further experience with radiation therapy and concomitant intravenous chemotherapy in advanced carcinoma of the lower female genital tract. Gynecol Oncol 43(3):233–236
Wharton JT, Rutledge FN, Gallager HS et al (1975) Treatment of clear cell adenocarcinoma in young females. Obstet Gynecol 45(4):365–368
McLaughlin CC, Wu XC, Jemal A et al (2005) Incidence of noncutaneous melanomas in the U.S. Cancer 103:1000–1007
Weinstock M (1994) Malignant melanoma of the vulva and vagina in the United States: patterns of incidence and population-based estimates of survival. Am J Obstet Gynecol 171:1225–1230
Ragnarsson-Olding B, Johansson H, Rutqvist L et al (1993) Malignant melanoma of the vulva and vagina. Cancer 71:1893–1897
Tasaka R, Fukuda T, Wada T et al (2017) A retrospective clinical analysis of 5 cases of vaginal melanoma. Mol Clin Oncol 6(3):373–376
Lai X, Friedman A (2017) Combination therapy for melanoma with BRAF/MEK inhibitor and immune checkpoint inhibitor: a mathematical model. BMC Syst Biol 11(1):70
Aulmann S, Sinn HP, Penzel R et al (2014) Comparison of molecular abnormalities in vulvar and vaginal melanomas. Mod Pathol 27(10):1386–1393
Hao C, Tian J, Liu H et al (2017) Efficacy and safety of anti-PD-1 and anti-PD-1 combined with anti-CTLA-4 immunotherapy to advanced melanoma: a systematic review and meta-analysis of randomized controlled trials. Medicine 96(26):e7325
Brand E, Fu YS, Lagasse LD et al (1989) Vulvovaginal melanoma: report of seven cases and literature review. Gynecol Oncol 33(1):54–60
Rapi V, Dogan A, Schultheis B et al (2017) Melanoma of the vagina: case report and systematic review of the literature. Anticancer Res 37:6911–6920. https://doi.org/10.21873/anticanres.12155
Kirschner AN, Kidd EA, Dewees T et al (2013) Treatment approach and outcomes of vaginal melanoma. Int J Gynecol Cancer 23(8):1484–1489
Peters WA 3rd, Kumar NB, Andersen WA et al (1985) Primary sarcoma of the adult vagina: a clinicopathologic study. Obstet Gynecol 65(5):699–704
Thigpen JT, Blessing JA, Homesley HD et al (1986) Phase II trial of cisplatin in advance or recurrent cancer of the vagina: a gynecologic oncology group study. Gynecol Oncol 23(1):101–104
Muss HB, Bundy B, DiSaia PJ et al (1985) Treatment of recurrent or advanced uterine sarcoma. A randomized trial of doxorubicin versus doxorubicin and cyclophosphamide (a phase III trial of the gynecologic oncology group). Cancer 55(8):1648–1653
Karam A, Berek JS, Kidd EA (2017) Vaginal cancer. https://www.uptodate.com/contents/vaginal-cancer. Accessed 12 Jan 2017
Grigsby PW (2002) Vaginal cancer. Curr Treat Options in Oncol 3(02):125–130. https://doi.org/10.1007/s11864-002-0058-4
Harris NL, Scully RE (1984) Malignant lymphoma and granulocytic sarcoma of the uterus and vagina. A clinicopathologic analysis of 27 cases. Cancer 53(11):2530–2545
Pampalakis G, Zingkou E, Sotiropoulou G (2018) KLK5, a novel potential suppressor of vaginal carcinogenesis. Biol Chem 399(9):1107–1111. https://doi.org/10.1515/hsz-2017-0302
Hollebecque A, Meyer T, Moore KN et al (2017) An open-label, multicohort, phase I/II study of nivolumab in patients with virus-associated tumors (CheckMate 358): efficacy and safety in recurrent or metastatic (R/M) cervical, vaginal, and vulvar cancers. http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.5504
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Nikolaou, M. (2019). Vaginal Cancer. In: De Mello, R., Mountzios, G., Tavares, Á. (eds) International Manual of Oncology Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-16245-0_24
Download citation
DOI: https://doi.org/10.1007/978-3-030-16245-0_24
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-16244-3
Online ISBN: 978-3-030-16245-0
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)