Vaginal cancer physical examination: Difference between revisions
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{{CMG}} {{AE}} {{sali}} | |||
{{Vaginal cancer}} | {{Vaginal cancer}} | ||
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==Overview== | |||
Complete [[pelvic]] examination is performed. During the [[speculum examination]], the [[vagina]] should be inspected thoroughly, including [[visualization]] of the entire circumference and the fornices by moving the position of the [[speculum]]. Any abnormal areas or [[masses]] should be [[biopsied]]. The [[bimanual examination]] should include [[palpation]] of the [[vaginal]] walls for masses and evaluation for other [[pelvic masses]]. The groins should be palpated to assess for enlarged [[lymph nodes]]. | |||
==Physical Examination== | |||
*The lesion may be missed on initial examination if it is small and situated in the lower two-thirds of the [[vagina]]<ref name="pmid26411952">{{cite journal |vauthors=Shrivastava SB, Agrawal G, Mittal M, Mishra P |title=Management of Vaginal Cancer |journal=Rev Recent Clin Trials |volume=10 |issue=4 |pages=289–97 |date=2015 |pmid=26411952 |doi= |url=}}</ref>. | |||
*During visual examination of the [[vagina]], the anterior and posterior blades of the speculum obscure this area, so the [[tumor]] may be missed unless the [[vagina]] is inspected as the [[speculum]] is removed or the lesion is palpated on [[bimanual examination]]. | |||
*[[Rectovaginal]] exam should also be performed to assess for parametrial and [[pelvic]] sidewall involvement and possible [[rectal]] involvement. | |||
*The posterior wall of the upper one-third of the [[vagina]] is the most common site of primary [[vaginal carcinoma]]. | |||
*The lesion may appear as a [[mass]], a plaque, or an [[ulcer]]<ref name="pmid25847318">{{cite journal |vauthors=Rajaram S, Maheshwari A, Srivastava A |title=Staging for vaginal cancer |journal=Best Pract Res Clin Obstet Gynaecol |volume=29 |issue=6 |pages=822–32 |date=August 2015 |pmid=25847318 |doi=10.1016/j.bpobgyn.2015.01.006 |url=}}</ref>. | |||
*Focused physical examination is performed to assess for [[metastatic]] disease<ref name="pmid26311914">{{cite journal |vauthors=Ng QJ, Namuduri RP, Yam KL, Lim-Tan SK |title=Vaginal metastasis presenting as postmenopausal bleeding |journal=Singapore Med J |volume=56 |issue=8 |pages=e134–6 |date=August 2015 |pmid=26311914 |pmc=4545142 |doi=10.11622/smedj.2015127 |url=}}</ref>. | |||
*The [[inguinal area]] should be examined for enlarged [[lymph nodes]]<ref name="pmid28541627">{{cite journal |vauthors=Lee IO, Lee JY, Kim S, Kim SW, Kim YT, Nam EJ |title=Sentinel lymph node mapping with indocyanine green in vaginal cancer |journal=J Gynecol Oncol |volume=28 |issue=4 |pages=e29 |date=July 2017 |pmid=28541627 |pmc=5447138 |doi=10.3802/jgo.2017.28.e29 |url=}}</ref>. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Gynecology]] | [[Category:Gynecology]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
Latest revision as of 03:50, 7 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]
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Overview
Complete pelvic examination is performed. During the speculum examination, the vagina should be inspected thoroughly, including visualization of the entire circumference and the fornices by moving the position of the speculum. Any abnormal areas or masses should be biopsied. The bimanual examination should include palpation of the vaginal walls for masses and evaluation for other pelvic masses. The groins should be palpated to assess for enlarged lymph nodes.
Physical Examination
- The lesion may be missed on initial examination if it is small and situated in the lower two-thirds of the vagina[1].
- During visual examination of the vagina, the anterior and posterior blades of the speculum obscure this area, so the tumor may be missed unless the vagina is inspected as the speculum is removed or the lesion is palpated on bimanual examination.
- Rectovaginal exam should also be performed to assess for parametrial and pelvic sidewall involvement and possible rectal involvement.
- The posterior wall of the upper one-third of the vagina is the most common site of primary vaginal carcinoma.
- The lesion may appear as a mass, a plaque, or an ulcer[2].
- Focused physical examination is performed to assess for metastatic disease[3].
- The inguinal area should be examined for enlarged lymph nodes[4].
References
- ↑ Shrivastava SB, Agrawal G, Mittal M, Mishra P (2015). "Management of Vaginal Cancer". Rev Recent Clin Trials. 10 (4): 289–97. PMID 26411952.
- ↑ Rajaram S, Maheshwari A, Srivastava A (August 2015). "Staging for vaginal cancer". Best Pract Res Clin Obstet Gynaecol. 29 (6): 822–32. doi:10.1016/j.bpobgyn.2015.01.006. PMID 25847318.
- ↑ Ng QJ, Namuduri RP, Yam KL, Lim-Tan SK (August 2015). "Vaginal metastasis presenting as postmenopausal bleeding". Singapore Med J. 56 (8): e134–6. doi:10.11622/smedj.2015127. PMC 4545142. PMID 26311914.
- ↑ Lee IO, Lee JY, Kim S, Kim SW, Kim YT, Nam EJ (July 2017). "Sentinel lymph node mapping with indocyanine green in vaginal cancer". J Gynecol Oncol. 28 (4): e29. doi:10.3802/jgo.2017.28.e29. PMC 5447138. PMID 28541627.