Thursday 6 March 2008

Vaginal cancer

Vaginal cancer
[Summary]



Vaginal cancer is often secondary, and can be spread directly from cervical cancer, or from endometrial cancer, ovarian cancer and choriocarcinoma, and the bladder, urethra, or rectal cancer are usually can be transferred to the vagina. Primary vaginal cancer is rare, accounting for about female genital mutilation 1% of malignant tumors. Primarily squamous cell carcinoma, Mao membrane cell carcinoma, such as carcinoma, sarcoma and malignant melanoma even more rare, many doctors in the obstetrics and gynecology medical practice, we saw only a few patients, due to vaginal secondary see more of the cancer, the diagnosis should be considered before the primary tumor and of secondary vaginal exclude the possibility of cancer.



[Treatment]




1. Treatment principles: treatment of vaginal cancer can be surgery or radiotherapy. Vaginal cancer, the treatment of cervical cancer with the next paragraph with vulvar cancer, and the middle of the two should be balanced, such as the bladder or rectum violations, to be organ of enucleation and diversions.

2. Surgical treatment: ① of radical hysterectomy, the vagina and underwent partial removal of pelvic lymph node, the previous paragraph applies to vaginal cancer early. ② genital, vaginal radical pelvic and inguinal lymph node removal or addition of, and applied to the vagina and the limitations of the smaller lesions. ③ above ① or ② increase organ and the evisceration of diversions. The wide scope of such surgery, trauma surgery and the risk of complications are greater, non-resort should not be used.

3. Radiation therapy: Radiation Therapy programme decisions on the location and tumor infiltration scope. Konglongbu tumor with the treatment of cervical cancer. Side of the vagina to the infiltration basin-wide external irradiation followed by local laser treatment. Vaginal cancer five-year survival rate is generally 35%. The cause of death due to multiple urinary system occlusion or infection caused uremia.


[Pathological changes:




The primary vaginal cancer occurs most often in the posterior vaginal fornix, and may stimulate the growth of related chronic. In short, the exact causes and pioneer conditions remain unclear. Pathologically generally There are three types: ① cauliflower type, such as delays in treatment, cauliflower-like tumors can be filled with the vagina. Chang began after vaginal wall occurred in 1 / 3 more highly differentiated cells, the exogenous type, rarely inside infiltration. ③ infiltrating or ulcer type, tumor formation ulcers, mainly seen in the anterior wall of the vagina, often rapid infiltration around the vagina. ③ mucosa of our development is slow, long confined to the mucosal layer, for vaginal carcinoma in situ. But with more vaginal carcinoma in situ or secondary to cervical carcinoma in situ or invasive cervical cancer peripheral changes. Histologically almost all primary vaginal cancer squamous cell carcinoma, adenocarcinoma of the few.



[Clinical]




Early can be asymptomatic after the symptoms are vaginal bleeding and abnormal vaginal discharge. General pain in advanced cancer. The lower part of vaginal cancer can be stimulated earlier in the bladder symptoms of vaginal cancer and cervical cancer diagnosis basically the same, including the Kuiqi careful examination, vaginal cytology, and biopsy biopsy.

Triple consultation, in addition to inspect local lesions, but also to the entire vagina and vaginal mucosa adjacent to the flexible organization involvement.


[Transfer and proliferation --




Because vaginal anatomy of the special relationship, (connective osteoporosis, thin wall, lymph rich), the spread of cancer easier. The main diffusion directly spread, lymph node metastasis and the occasional distant metastasis. Vaginal cancer in the lymph node metastasis of basic channels with cervical cancer; vaginal 1 / 3 basic with vulvar cancer; 1 / 3 can be transferred from top to bottom in two ways.
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