What is cancer of the vagina -
Vaginal cancer can be primary and metastatic ( secondary ) . Of all malignant diseases of the genital organs of women primary vaginal cancer is 1-2 % , can occur at any age , but mainly in the 50-60 years .
In most cases, vaginal cancer is metastatic , it is - a consequence of the transition process with malignant uterine body and cervix to the vaginal wall . Metastatic cancer of the vagina in the vaults and the lower third .
What Causes Cancer of the vagina :
Predominant age - 45-65 years: squamous option - 35-70 years for clear cell carcinoma.
For women exposed prenatally exposed to diethylstilbestrol (DES), the average age of the development of clear cell adenocarcinoma of the vagina is 19.5 years.
The risk of developing this cancer in women under the age of 24 years who underwent DES in utero effects , ranging from 0.14 / 1,000 to 1.4 / 1,000.
Cause unknown vaginal tumors , clear cell adenocarcinoma of the exception - its appearance is associated with exposure to DES . DES was used in the 40- 50s to maintain pregnancy in women at high risk - diabetes, habitual abortion, threatened abortion and other obstetric complications . In all cases of adenocarcinoma receiving DES started to 18 weeks of pregnancy .
Risk factors for vaginal cancer :
Adenosis of the vagina. Normally, the vagina is lined with flat cells - epithelium. In 40% of cases after the onset of menses in the vagina can appear zone glandular cells , as in the uterus. This phenomenon is called adenosis and may slightly increase the risk of clear cell adenocarcinoma of the vagina regardless of the DRC .
Infection caused by the human papilloma virus (HPV). This group includes more than 70 types of viruses that can cause papillomas . Various types of viruses cause different papillomavirus in many areas of the body ( on the palms and soles , lips and tongue , male and female genitals and anus ) . The viruses are transmitted from person to person through sexual contact. These viruses are found in tumor cells of some of the vagina.
Early sexual debut , having many sexual partners , ignoring protection increases the risk of infection by human papilloma viruses .
Cervical cancer and precancerous changes in the cervix increase the risk of squamous cell carcinoma of the vagina. Radiotherapy , held earlier in the area of cervical cancer also increases the risk of vaginal cancer , possibly due to damage to the DNA of cells of the vagina.
Irritation of the vagina in women using pessaries with uterine prolapse leads to chronic inflammation of the vagina and some increase in the risk of developing squamous cell carcinoma .
Smoking , especially at a young age may play a role in the development of cancer of the vagina. Such an assumption is made on the grounds that women suffering from vaginal cancer , lung cancer is often diagnosed , which is directly related to tobacco use.
Distinguish exophytic form of growth , when the tumor is represented protruding above the vaginal walls papillary growths resembling cauliflower and endophytic when the neoplastic process from the beginning grows into the underlying tissues , infiltrating them .
Pathogenesis (what's going on? ) During vaginal cancer :
Vaginal cancer pathogenesis is poorly understood. Background for the development of dysplasia and then cancer of the vagina can be hydrocyanic colpites arising from involutive and degenerative changes in the elderly and old age , not exclude the role of viral infection in the pathogenesis of the disease . The possibility of genesis radioindutsirovanogo vaginal cancer after combined -beam treatment of malignant tumors of the uterus.
By analogy with cervical intraepithelial neoplasia (CIN) are distinguished vaginal intraepithelial neoplasia (VAIN) to a mild, moderate and severe dysplasia (VAIN 1 , 2. 3) and Ca in situ.
The histological distinction squamous keratinizing and neorogovevayuschy , at least - glandular cancer .
Under the rules adopted by FIGO, the combination of cervical and vaginal process classified as cervical cancer. With the defeat of a malignant tumor of the external genitalia and the outer third of the vagina should be considered a primary cancer of the external genitalia .
Classification of vaginal cancer :
• Stage 0 - preinvasive carcinoma (synonyms Ca in situ, intraepithelial cancer) ;
• Stage 1 - tumor diameter of 2 cm , grows deeper than the submucosa , regional metastases are not defined ;
• II stage - a tumor larger than 2 cm in diameter with the same depth of invasion or tumor of the same or smaller size with paravaginalnym infiltrate, not extending to the pelvic walls , regional metastases are not defined ;
• III stage - a tumor of any size with paravaginalnym infiltrate extending to the walls of the pelvis , with movable regional metastases ;
• IV stage - a tumor of any size invades adjacent organs ( mucosa of the urethra , bladder, rectum) and fabrics ( the perineum , the pelvic bone ) with fixed regional metastases or distant metastases.
Histological classification of vaginal cancer
• Squamous cell variant, which develops from cells lining the vagina ( epithelium) . - 95 %.
This type of cancer occurs mainly in the area of the cervix . Cancer develops over many years against the backdrop of precancerous changes - vnutriepiteli -tion vaginal neoplasia ( BHB ) .
• Primary and secondary adenocarcinoma.
• Secondary squamous cell carcinoma ( in old age ) .
• clear cell adenocarcinoma ( at a young age ) - a kind of consider DES -dependent adenocarcinoma .
• Pigmented tumors - melanoma - is 2-3% of the total number of neoplastic diseases of the vagina. This type of cancer is usually located in the lower vagina and vary in size, color and character growth.
• 2-3 % represented vaginal tumors sarcomas , which arise in the back wall of the vagina :
• leiomyosarcoma develop from smooth muscle and usually affect women over 50 years.
• Rhabdomyosarcoma arises from cross- striated ( skeletal ) muscle and is usually diagnosed in children under the age of 2 years.
Symptoms of vaginal cancer : In the early stages of the disease remains asymptomatic vaginal cancer . In subsequent cables appear spontaneous or contact sukrovichnye from the genital tract . As the growth and decay of the tumor attached to the pubic pain , sacrum and inguinal areas violated function of adjacent organs ( appear frequent urination , difficulty in defecation ) , and later develops white or blue swelling of the lower extremities.
Initially, the tumor may have the character of a small ulceration , papillary growths or submucosal infiltration . Tissue in the pathological focus characterized by high density. Later exophytic tumor acquires the hilly terrain, easily injured and bleeds ; around the tumor ulcerative character appears dense valikoobrazny edge ; cancer with infiltrative growth and woody stationary density.
Vaginal cancer can be primary and metastatic ( secondary ) . Of all malignant diseases of the genital organs of women primary vaginal cancer is 1-2 % , can occur at any age , but mainly in the 50-60 years .
In most cases, vaginal cancer is metastatic , it is - a consequence of the transition process with malignant uterine body and cervix to the vaginal wall . Metastatic cancer of the vagina in the vaults and the lower third .
What Causes Cancer of the vagina :
Predominant age - 45-65 years: squamous option - 35-70 years for clear cell carcinoma.
For women exposed prenatally exposed to diethylstilbestrol (DES), the average age of the development of clear cell adenocarcinoma of the vagina is 19.5 years.
The risk of developing this cancer in women under the age of 24 years who underwent DES in utero effects , ranging from 0.14 / 1,000 to 1.4 / 1,000.
Cause unknown vaginal tumors , clear cell adenocarcinoma of the exception - its appearance is associated with exposure to DES . DES was used in the 40- 50s to maintain pregnancy in women at high risk - diabetes, habitual abortion, threatened abortion and other obstetric complications . In all cases of adenocarcinoma receiving DES started to 18 weeks of pregnancy .
Risk factors for vaginal cancer :
Adenosis of the vagina. Normally, the vagina is lined with flat cells - epithelium. In 40% of cases after the onset of menses in the vagina can appear zone glandular cells , as in the uterus. This phenomenon is called adenosis and may slightly increase the risk of clear cell adenocarcinoma of the vagina regardless of the DRC .
Infection caused by the human papilloma virus (HPV). This group includes more than 70 types of viruses that can cause papillomas . Various types of viruses cause different papillomavirus in many areas of the body ( on the palms and soles , lips and tongue , male and female genitals and anus ) . The viruses are transmitted from person to person through sexual contact. These viruses are found in tumor cells of some of the vagina.
Early sexual debut , having many sexual partners , ignoring protection increases the risk of infection by human papilloma viruses .
Cervical cancer and precancerous changes in the cervix increase the risk of squamous cell carcinoma of the vagina. Radiotherapy , held earlier in the area of cervical cancer also increases the risk of vaginal cancer , possibly due to damage to the DNA of cells of the vagina.
Irritation of the vagina in women using pessaries with uterine prolapse leads to chronic inflammation of the vagina and some increase in the risk of developing squamous cell carcinoma .
Smoking , especially at a young age may play a role in the development of cancer of the vagina. Such an assumption is made on the grounds that women suffering from vaginal cancer , lung cancer is often diagnosed , which is directly related to tobacco use.
Distinguish exophytic form of growth , when the tumor is represented protruding above the vaginal walls papillary growths resembling cauliflower and endophytic when the neoplastic process from the beginning grows into the underlying tissues , infiltrating them .
Pathogenesis (what's going on? ) During vaginal cancer :
Vaginal cancer pathogenesis is poorly understood. Background for the development of dysplasia and then cancer of the vagina can be hydrocyanic colpites arising from involutive and degenerative changes in the elderly and old age , not exclude the role of viral infection in the pathogenesis of the disease . The possibility of genesis radioindutsirovanogo vaginal cancer after combined -beam treatment of malignant tumors of the uterus.
By analogy with cervical intraepithelial neoplasia (CIN) are distinguished vaginal intraepithelial neoplasia (VAIN) to a mild, moderate and severe dysplasia (VAIN 1 , 2. 3) and Ca in situ.
The histological distinction squamous keratinizing and neorogovevayuschy , at least - glandular cancer .
Under the rules adopted by FIGO, the combination of cervical and vaginal process classified as cervical cancer. With the defeat of a malignant tumor of the external genitalia and the outer third of the vagina should be considered a primary cancer of the external genitalia .
Classification of vaginal cancer :
• Stage 0 - preinvasive carcinoma (synonyms Ca in situ, intraepithelial cancer) ;
• Stage 1 - tumor diameter of 2 cm , grows deeper than the submucosa , regional metastases are not defined ;
• II stage - a tumor larger than 2 cm in diameter with the same depth of invasion or tumor of the same or smaller size with paravaginalnym infiltrate, not extending to the pelvic walls , regional metastases are not defined ;
• III stage - a tumor of any size with paravaginalnym infiltrate extending to the walls of the pelvis , with movable regional metastases ;
• IV stage - a tumor of any size invades adjacent organs ( mucosa of the urethra , bladder, rectum) and fabrics ( the perineum , the pelvic bone ) with fixed regional metastases or distant metastases.
Histological classification of vaginal cancer
• Squamous cell variant, which develops from cells lining the vagina ( epithelium) . - 95 %.
This type of cancer occurs mainly in the area of the cervix . Cancer develops over many years against the backdrop of precancerous changes - vnutriepiteli -tion vaginal neoplasia ( BHB ) .
• Primary and secondary adenocarcinoma.
• Secondary squamous cell carcinoma ( in old age ) .
• clear cell adenocarcinoma ( at a young age ) - a kind of consider DES -dependent adenocarcinoma .
• Pigmented tumors - melanoma - is 2-3% of the total number of neoplastic diseases of the vagina. This type of cancer is usually located in the lower vagina and vary in size, color and character growth.
• 2-3 % represented vaginal tumors sarcomas , which arise in the back wall of the vagina :
• leiomyosarcoma develop from smooth muscle and usually affect women over 50 years.
• Rhabdomyosarcoma arises from cross- striated ( skeletal ) muscle and is usually diagnosed in children under the age of 2 years.
Symptoms of vaginal cancer : In the early stages of the disease remains asymptomatic vaginal cancer . In subsequent cables appear spontaneous or contact sukrovichnye from the genital tract . As the growth and decay of the tumor attached to the pubic pain , sacrum and inguinal areas violated function of adjacent organs ( appear frequent urination , difficulty in defecation ) , and later develops white or blue swelling of the lower extremities.
Initially, the tumor may have the character of a small ulceration , papillary growths or submucosal infiltration . Tissue in the pathological focus characterized by high density. Later exophytic tumor acquires the hilly terrain, easily injured and bleeds ; around the tumor ulcerative character appears dense valikoobrazny edge ; cancer with infiltrative growth and woody stationary density.
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