Female genital cancers are an important cause of death in women. Numerous types of vaginal and vulvar cancers are seen in clinical practice, with main symptoms being vaginal bleeding, discharge, pruritus, local pain, and the presence of a mass. The diagnosis and identification of the exact tumor type rest on clinical criteria, findings obtained from imaging studies, and a properly obtained biopsy.
Presentation
More than 100,000 new cancers of the female reproductive tract are diagnosed in the United States every year [1], suggesting its rather important place in the overall mortality from malignant diseases in women. Vulvar and vaginal cancers account for approximately 10% of all gynecological neoplasias and are not as common as uterine or ovarian cancer [1]. The two respective types somewhat differ in their pathogenesis and clinical presentation [2] [3] [4] [5] [6]:
- Vulvar carcinoma - Squamous carcinoma of the epithelium is the most common type of vulvar carcinoma, followed by melanoma, adenocarcinoma, sarcoma, and Bartholin gland carcinoma [5] [6]. Studies hypothesize that human papillomavirus (HPV) infection plays an important role in its development in younger populations, whereas cellular atypia, mainly as a result of advanced age might also be a possible risk factor [3]. Pruritus is considered to be the main symptom, while vulvar bleeding, discharge, local pain, and dysuria are less common findings [3]. In some patients, a palpable mass may be detected, with a necrotic, ulcerating or warting appearance [3].
- Vaginal carcinoma - Similarly to vulvar carcinoma, squamous cell carcinoma comprises the vast majority of cancers stemming from the vagina, and are primarily seen in postmenopausal women [4]. Involvement of HPV in the pathogenesis is also established, and a significant number of women already suffer from a malignant disease arising from the vulva or the cervix [4]. Adenocarcinomas, melanomas, and metastatic tumors (from gynecologic and non-gynecologic origins) are other important types [4]. The clinical presentation includes painless vaginal bleeding and discharge, pelvic pain, a palpable mass, and urinary tract-related symptoms, but up to a quarter of patients may be asymptomatic [4].
Entire Body System
- Localized Pain
Numerous types of vaginal and vulvar cancers are seen in clinical practice, with main symptoms being vaginal bleeding, discharge, pruritus, local pain, and the presence of a mass. [symptoma.com]
Physical findings: Individuals with SCC FGT may be asymptomatic but usually present with: • Localized pain; • Vaginal bleeding; • Abdominal bloating or a mass; or • Symptoms of metastasis disease to the liver, bone, lung, or regional lymph nodes. [secure.ssa.gov]
Workup
The prognosis of vulvar and vaginal cancers directly depends on the stage, and given the fact that an early local spread is observed for both tumors, a prompt diagnosis is of critical importance. The workup of female genital cancers involves a multistep process, starting with a thorough patient history and a meticulous physical examination, with an emphasis on the duration of symptoms and their progression and a detailed genital examination, respectively. Once sufficient clinical criteria exist for further evaluation, imaging studies must be employed. Various procedures have been described, including ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose-positron emission tomography (FDG-PET) [2] [3] [7] [8] [9] [10]. In order to establish the tumor stage, it is important to assess the extent of tumor spread into local, but also distant tissues. MRI is considered to be a superior method for evaluation of local tumor invasion due to its higher sensitivity for discriminating soft-tissue structures, whereas both CT and MRI, but also FDG-PET might be performed if a nodal or metastatic spread is suspected [2] [4] [9]. Finally, a biopsy of the tumor provides important information regarding the degree of cellular proliferation, after which a definite diagnosis can be made [4] [6].
Treatment
Pregnancy after breast cancer treatment has been shown to develop properly and both, pregnancy and breastfeeding have no influence on cancer relapse. [ncbi.nlm.nih.gov]
When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Clinical trials are taking place in many parts of the country. [medifitbiologicals.com]
The first half of the seminar looked at the treatment of FGS cancers with Dr Vikash Chatrani informing the audience about the ever-prevalent benign tumours called fibroids and the best practice for treatment and counseling the patient. [bnr.org.bb]
180.1;180.8; 183.0; 183.2; 183.3; 183.5; 183.8; 183.9;184.4; 184.8; 184.9 TREATMENT There is no standard treatment for SCC FGT. [secure.ssa.gov]
Prognosis
Management and prognosis The prognosis of patients with gastric cancer with metastasis to the ovaries has been reported to be poorer compared with that of other primary tumors ( 3, 14, 23 ). [spandidos-publications.com]
Prognosis The prognosis of vaginal cancer includes factors such as the stage of cancer, tumor size, age, general health condition, recurrence and location of the tumor. [cancerwall.com]
The prognosis of vulvar and vaginal cancers directly depends on the stage, and given the fact that an early local spread is observed for both tumors, a prompt diagnosis is of critical importance. [symptoma.com]
He went on to share on the signs, prognosis, and surgical as well as non-surgical interventions of malignant tumours. [bnr.org.bb]
What is the prognosis? The outlook (prognosis) is best in those who are diagnosed when the cancer of the vulva (vulval cancer) is at an early stage. Surgical removal of a small vulval cancer gives a good chance of cure. [patient.info]
Etiology
Rosenberg SA (eds): AIDS: Etiology, Diagnosis. Treatment, and Prevention. الصفحة 190 - Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. الصفحة 193 - Henson D, Tarone R. [books.google.com]
As soon as the etiologic association was recognized, use of unopposed estrogens declined dramatically, and incidence rates also began to decline. This effect seems to have been delayed by about four years in Canada. [bmcwomenshealth.biomedcentral.com]
This suggests that a single etiologic factor is unlikely. [emedicine.medscape.com]
Etiology of vulvar cancer will impact on treatment options and therapy outcome: Two major pathways of vulvar cancer. Gynecologic Oncology. Oct 2013; 131(1):246-247. Viswanathan C, Kirschner K, Truong M, Balachandran A, Devine C, Bhosale P. [oncolink.org]
Noncontiguous spread of hematological, lymphatic or Fallopian tube etiology usually results in diffuse uterine enlargement with complete loss of the junctional zone on MRI ( 50, 51 ). [spandidos-publications.com]
Epidemiology
Diagnostic criteria and microbial and epidemiologic associations. Am J Med. Seite 193 - Henson D, Tarone R. An epidemiologic study of cancer of the cervix, vagina, and vulva based on the Third National Cancer Survey in the United States. [books.google.de]
Diagnostic criteria and microbial and epidemiologic associations. Am J Med. الصفحة 193 - Henson D, Tarone R. An epidemiologic study of cancer of the cervix, vagina, and vulva based on the Third National Cancer Survey in the United States. [books.google.com]
Other epidemiologic and risk factor information was found in published surveillance and research reports. [bmcwomenshealth.biomedcentral.com]
タイトル Tobacco smoking and cancer: a brief review of recent epidemiological evidence. 雑誌 Lung Cancer 45 Suppl 2:S3-9 (2004) DOI: 10.1016/j.lungcan.2004.07.998 文献 PMID: 12612656 (marker) 著者 Baldwin P, Laskey R, Coleman N. [genome.jp]
Epidemiological studies in various regions of Pakistan are required to study the pattern of female genital tract malignancies. Thus a true picture of genital cancer in Pakistan will emerge. References 1. Jafarey, N.A. and Zaidi, S.H.M. [jpma.org.pk]
Pathophysiology
FEMALE GENITAL TRACT CANCERS PATHOPHYSIOLOGY Malignant diseases of the vagina are either primary vaginal cancers or metastatic cancers from adjacent or distant organs. [medifitbiologicals.com]
Adenocarcinoma can arise from the Bartholin gland and present with a painful lump. [19] Causes [ edit ] Two main pathophysiological pathways are currently understood to contribute to development of vulvar cancer - human papillomavirus (HPV) infection [en.wikipedia.org]
Prevention
However, the overall effectiveness of preventing against cervical cancer has not been demonstrated. [www2.gov.bc.ca]
Dr Broome described current and future methods of HPV prevention and gave an update on the Barbados HPV vaccination programme. [bnr.org.bb]
I call it Immunizer - just a simple exercise, but The Complete Colds/Flus/AIDS/STD/HPV/HBV/HCV/West Nile/Yosemite/Cancers Prevention - normally done for a minute a day for kids and adults as the full prevention of the major plagues of civilization. [books.google.com]
HPV vaccination can prevent cancer: HPV vaccines can prevent infection with disease-causing HPV types, preventing many HPV-related cancers and cases of genital warts. [cancer.gov]
Having the Cervical Screening Test every 5 years (which has replaced the Pap smear) is essential for all women who have ever been sexually active to help prevent cervical cancer. [healthdirect.gov.au]
References
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30.
- Gardner CS, Sunil J, Klopp AH, et al. Primary vaginal cancer: role of MRI in diagnosis, staging and treatment. Br J Radiol. 2015;88(1052):20150033.
- Alkatout I, Schubert M, Garbrecht N, et al. Vulvar cancer: epidemiology, clinical presentation, and management options. Int J Womens Health. 2015;7:305-313.
- Parikh JH, Barton DP, Ind TE, Sohaib SA. MR imaging features of vaginal malignancies. Radiographics. 2008;28(1):49-63.
- Herr D, Juhasz-Boess I, Solomayer EF. Therapy for Primary Vulvar Carcinoma. Geburtshilfe Frauenheilkd. 2014;74(3):271-275.
- Hill-Daniel J, Roett MA. Genital Cancers in Women: Vulvar Cancer. FP Essent. 2015;438:31-43; quiz 44-8.
- Lamoreaux WT, Grigsby PW, Dehdashti F, et al. FDG-PET evaluation of vaginal carcinoma. Int J Radiat Oncol Biol Phys. 2005;62(3):733-737.
- Taylor MB, Dugar N, Davidson SE, Carrington BM. Magnetic resonance imaging of primary vaginal carcinoma. Clin Radiol. 2007;62(6):549-555.
- Lee LJ, Jhingran A, Kidd E, et al. Acr appropriateness Criteria management of vaginal cancer. Oncology (Williston Park). 2013;27(11):1166-1173.
- Sohaib SA, Richards PS, Ind T, et al. MR imaging of carcinoma of the vulva. AJR Am J Roentgenol. 2002;178(2):373–377.