Cancerous tumours of the vagina

A cancerous tumour of the vagina can grow into and destroy nearby tissue. It can also spread (metastasize) to other parts of the body. Cancerous tumours are also called malignant tumours. Primary vaginal cancer (cancer that starts in the vagina) is not common. When cancer is found in the vagina it has more often started in other organs (most often the cervix or vulva) and spread to the vagina.

Squamous cell carcinoma (SCC) begins in the squamous cells that make up the epithelial lining of the vagina. It is the most common type of vaginal cancer.

SCC makes up about 85% of vaginal cancers and occurs most often in women age 60 and older. It is most likely to occur in the upper area of the vagina near the cervix. It starts with precancerous changes in the epithelium called vaginal intraepithelial neoplasia (VAIN). The precancerous changes may then develop into cancer. It usually develops slowly over many years.

Verrucous carcinoma is a rare subtype of squamous cell carcinoma. Most of the time it doesn’t spread outside the vagina, but it may come back to the original site (local recurrence) after surgery.

Adenocarcinoma begins in the glandular cells of the vagina. Glandular cells make mucus, hormones and lubricating fluids. It is the 2nd most common type of vaginal cancer. Adenocarcinoma makes up about 15% of vaginal cancers and occurs most often in women age 50 and older.

Clear cell carcinoma is a type of adenocarcinoma that occurs most often in women whose mothers took diethylstilbestrol (DES) during their first 16 weeks of pregnancy. DES is a synthetic form of estrogen that was used between 1940 and 1971 to help prevent miscarriage in women who had certain problems during pregnancy.

Vaginal adenosis is a condition in which areas of glandular cells have replaced the squamous cells that normally line the vagina. It is found in nearly all women who were exposed to DES before birth. Having vaginal adenosis increases the risk of clear cell carcinoma.

Melanoma begins in the melanocytes, which are cells in the vagina that make pigment. Melanoma makes up about 3% of vaginal cancers, and the average age of women diagnosed with it is 55. It most often begins in the lower third and front wall of the vagina. The tumours vary in size, colour and growth patterns.

Sarcoma begins in the muscle or connective tissue cells of the vagina. These cells are deep in the walls of the vagina. Sarcoma makes up about 3% of vaginal cancers.

• Leiomyosarcoma accounts for two-thirds of vaginal sarcomas. It is most often diagnosed in women age 50 and older.
• Other types of vaginal sarcoma include endometrial stromal sarcoma and malignant mixed Müllerian tumours.
• Embryonal rhabdomyosarcoma (sarcoma botryoides) is a vaginal sarcoma most often found in children up to 6 years of age. It is rarely found in adults.