3. Vagina

Question 1

Diseases of the vagina

Answer 1

1. Congenital anomalies
2. Vaginal intraepithelial neoplasia (VAIN)
3. Clear cell adenocarcinoma of the vagina
4. Embryonal rhabdomyosarcoma (Sarcoma Botryoides)

Question 2

Etiology of vaginal cancer

Answer 2

same as vulvar neoplasia (e.g., HPV 16 and 18)

Question 3

Subtypes of vaginal cancer

Answer 3

1. Squamous cell carcinoma
2. Clear cell adenocarcinoma
3. Sarcoma botryoides

Question 4

Squamous cell carcinoma of the vagina

Answer 4

1. Most common type

2. Usually occurs secondary to cervical squamous cell carcinoma, primary carcinoma is rare

Question 5

Clear cell adenocarcinoma

Answer 5

1. Usually occurs secondary to vaginal adenosis (the presence of glandular columnar epithelium within the upper two-thirds of the vaginal wall)
2. Seen in daughters of women who received diethylstilbestrol during pregnancy

Question 6

Sarcoma botryoides

Answer 6

Rare, highly malignant embryonal rhabdomyosarcoma that arises most commonly, but not exclusively in the genitourinary system

Question 7

Epidemiology of sarcoma botryoides

Answer 7

Peak incidence in childhood (< 4 years)

Question 8

Pathology of sarcoma botryoides

Answer 8

1. Gross: clear, polypoid masses that resemble a bunch of grapes protruding through the vagina
2. Microscopy: pleomorphic spindle-shaped cells
3. Immunohistochemical staining: desmin positive

Question 9

Symptoms of vaginal cancer

Answer 9

1. Vaginal bleeding
2. Leukoplakia, vaginal ulceration with contact bleeding
3. Malodorous discharge
4. Possibly urinary frequency