Vaginal carcinoma, vulvar carcinoma : vaginal carcinoma
Definition
Vaginal cancer (Vaginal carcinoma) is a very rare malignant change of the vaginal epithelium. Due to its rarity and the difficulties in detecting the vaginal carcinoma at an early stage, the chances of recovery are rather poor.
What can be typical signs?
In its early stages, vaginal cancer often causes no symptoms and therefore remains undetected for a long time. Typical signs of vaginal cancer can be bleeding outside the period, unusual discharge, unpleasant odor, pain when urinating or during sexual intercourse. Women who are affected by one or more of these symptoms must urgently consult a gynecologist and clarify the symptoms with him or her.
Primary vaginal carcinomas are very rare. The incidence is estimated at 0.5 per 100,000 women. Squamous cell carcinomas (starting from the epithelium of the skin/mucosa) are most common in older women.
They occur in 90% of cases. They are followed by light-cell adenocarcinomas (originating from glandular tissue). Even rarer than these are sarcomas (originating from connective tissue) or melanomas (pigment cell tumor) of the vagina.
About half of these carcinomas are located in the upper third of the vagina, the other half on the vaginal wall. Much more frequently, the vagina is considered the site of secondary spread of a tumor. Tumors of the uterus, ovaries, rectum or bladder often spread to the vagina and lead to metastases.
Origin of disease
Squamous cell carcinoma (vaginal cancer) can originate from any cell of the vagina. Most often, however, it develops in the posterior vaginal vault. In the past, mothers were treated with diethylstilbestrol to prevent premature birth.
1% of the girls born suffered from a light-cell adenocarcinoma of the vagina during childhood. The vast majority of cases were observed in the USA. In Germany, none of these incidents are known.
This shows that high-dose estrogen treatment during the embryonic period can have a carcinogenic effect. Another risk factor for vaginal cancer is human papilloma virus (HPV) types 16 and 18, which cause wart-like changes in the mucous membrane and can degenerate. Vaginal cancer grows very quickly into the surrounding connective tissue.
Thus it attacks aggressively the bladder, rectum and uterus (where corresponding polyps may also have appeared as a precursor). over. Due to the pronounced lymph node supply of the vagina, metastasis quickly spreads into the lymph nodes and thus into other organs.
The stages of vaginal carcinoma (vaginal cancer) are classified according to FIGO or TNM classification. A distinction is made as to how many organs are affected or whether the carcinoma is restricted to the vagina. On the other hand, the lymph node involvement is indicated and metastases to more distant organs.
FIGO distinguishes 6 stages. The subdivision is made according to the spread of the carcinoma into the surrounding area. Stage 1 means “carcinoma in situ” (so-called surface carcinoma).
Stage 6 means a spread to distant organs. Depending on the stage, the chances of cure are very poor. The therapy becomes more difficult and more hopeless if the tumor has spread into the lymph nodes and has already affected other organs.
