Edit concept Question Editor Create issue ticket

Female Genital Cancer

Malignant Neoplasm of female Genital Organ

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].
Asymptomatic
  • 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.[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]
  • Our study subjects included women who presented to outpatient clinics who were mostly asymptomatic but were screened for cervical cancer, and women with cancer symptoms who were referred to the Hopital Le Dantec for cervical cancer treatment.[digital.lib.washington.edu]
  • TOP Screening Cervical Cancer In BC, conventional Pap test (also known as cervical cytology) is currently the only test used for the cervical cancer screening program for asymptomatic females.[www2.gov.bc.ca]
  • These include: A lump or ulceration on the vulva Itching or irritation Bleeding or discharge Vaginal cancers are more commonly asymptomatic, and are found on routine gynecologic examinations or may result in an abnormal Pap smear.[cedars-sinai.edu]
Recurrent Infection
  • Its long-term consequences include recurrent infection, urinary incontinence, pain with intercourse, complications during childbirth, and psychological effects.[digital.lib.washington.edu]
Falling
  • Sexually transmitted HPV types fall into two groups, low risk and high risk. Low-risk HPVs mostly cause no disease. However, a few low-risk HPV types can cause warts on or around the genitals, anus, mouth, or throat.[cancer.gov]
Common Cold
  • And I am also sure everybody can be like me - untouchable for any diseases - from the common cold to cancer...[books.google.com]
Chronic Cough
  • Your recognised location is United States (US) Chronic cough in a child This article is freely available only to users in the UK.[evidence.nhs.uk]
Withdrawn
  • ClinicalTrials.gov Identifier: NCT00382330 Recruitment Status : Withdrawn First Posted : September 29, 2006 Last Update Posted : September 6, 2013 Sponsor: Information provided by (Responsible Party): Rutgers, The State University of New Jersey ( University[clinicaltrials.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]
  • 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]
  • Treatment is recommended for all women with vulvar HSIL (VIN usual type).[markrosengartenmd.ca]
  • Although preventable, the absence of regular screening and appropriate treatment for cervical cancer leads to late diagnosis and high mortality in African women.[digital.lib.washington.edu]

Prognosis
  • 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]
  • 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]
  • 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]
  • Verrucous carcinoma is an uncommon subtype that's important to recognize because it's slow-growing and tends to have a good prognosis (outlook).[cancer.org]

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]

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]
  • International Collaboration of Epidemiological Studies of Cervical Cancer.[www2.gov.bc.ca]
  • 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]
Sex distribution
Age distribution

Prevention
  • 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]
  • However, the overall effectiveness of preventing against cervical cancer has not been demonstrated.[www2.gov.bc.ca]
  • 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]
  • There are no screening strategies for the prevention of vulvar cancer through early detection of vulvar HSIL (VIN usual type). Treatment is recommended for all women with vulvar HSIL (VIN usual type).[markrosengartenmd.ca]

References

Article

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30.
  2. 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.
  3. Alkatout I, Schubert M, Garbrecht N, et al. Vulvar cancer: epidemiology, clinical presentation, and management options. Int J Womens Health. 2015;7:305-313.
  4. Parikh JH, Barton DP, Ind TE, Sohaib SA. MR imaging features of vaginal malignancies. Radiographics. 2008;28(1):49-63.
  5. Herr D, Juhasz-Boess I, Solomayer EF. Therapy for Primary Vulvar Carcinoma. Geburtshilfe Frauenheilkd. 2014;74(3):271-275.
  6. Hill-Daniel J, Roett MA. Genital Cancers in Women: Vulvar Cancer. FP Essent. 2015;438:31-43; quiz 44-8.
  7. 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.
  8. Taylor MB, Dugar N, Davidson SE, Carrington BM. Magnetic resonance imaging of primary vaginal carcinoma. Clin Radiol. 2007;62(6):549-555.
  9. Lee LJ, Jhingran A, Kidd E, et al. Acr appropriateness Criteria management of vaginal cancer. Oncology (Williston Park). 2013;27(11):1166-1173.
  10. Sohaib SA, Richards PS, Ind T, et al. MR imaging of carcinoma of the vulva. AJR Am J Roentgenol. 2002;178(2):373–377.

Ask Question
5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!
Last updated: 2019-07-11 20:58