Vaginal cancer classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Vaginal cancer may be classified according to histopathology into squamous cell carcinoma, adenocarcinoma, vaginal germ cell tumor, and vaginal sarcoma.

Types of vaginal cancer

Types of vaginal cancer, in order of prevalence, include:

• Vaginal squamous cell carcinoma:

• Squamous cell carcinoma accounts for the majority of vaginal cancers.
• The mean age at diagnosis of squamous cell carcinomas is approximately 60 years.
• These tumors may be nodular, ulcerative, indurated, endophytic, or exophytic.
• Vaginal cancer is also associated with the human papillomavirus (HPV).
• Vaginal epithelium is more stable than cervical epithelium, which undergoes constant metaplasia, and is less susceptible to oncogenic viruses.
• Verrucous carcinoma is a less common variant of vaginal squamous cell carcinoma that is well-differentiated and has low malignant potential.
• It usually presents as a large, warty, fungating mass that is locally aggressive but rarely metastasizes.

• Vaginal adenocarcinoma:

• Approximately 15%, second most common subtype, presents in younger individuals and arises from the glandular (secretory) cells in the lining of the vagina that produce some vaginal fluids.
• Adenocarcinoma is more likely than squamous cell cancer to spread to the lungs and lymph nodes.
• The majority of cases of adneocarcinoma occur in women younger than 30 years and has been found in a small percentage of women whose mothers in the 1950s used diethylstilbestrol to prevent threatened abortions.

• Clear cell carcinoma of the vagina: rare, associated with previous diethylstilbestrol (DES) exposure

• Vaginal germ cell tumors:

• These are rare (primarily teratoma and endodermal sinus tumor), and the majority of cases occur in infants and children.

• Vaginal sarcoma:

• Rhabdomyosarcoma in pediatric population, eg. sarcoma botryoides