Vaginal Cancer

by Carlo Raj, MD

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    00:01 Under female reproductive pathology, let us now take a look at vaginal disorders.

    00:06 Our first topic here will be vaginal tumor.

    00:10 If you take a look at the histologic picture here, you can notice that you find keratin pearls.

    00:18 As soon as you hear about keratin pearls or see keratin pearls, you can’t see the intracellular bridges but they’re called prickles in pathology.

    00:27 The point is we’re talking about squamous cell cancer.

    00:31 It is uncommon.

    00:34 The greatest risk factor here will be that of which we’ve seen with cervical and with vulvar referring to HPV high-risk strain.

    00:44 This will give rise to a squamous cell cancer of your vagina.

    00:48 Rare, but know it.

    00:51 Here, we’ll take a look at a vaginal tumor is of the adenocarcinoma type.

    00:55 That in itself is rather bizarre.

    00:57 The reason I say that is if you remember correctly that the pH within the vagina is decreased And the reason for that is because of the lactobacillus.

    01:06 Therefore, creating or sustaining a squamous type of environment.

    01:12 The fact that you find a glandular type of cancer within the vagina is rare.

    01:17 And secondly, high on your differential.

    01:20 And historically, you should be thinking about a mother who had taken diethylstilbestrol in which her daughter starts developing an adenocarcinoma of the vagina at the tender age of 15 to 20.

    01:32 This is a really young lady who ends up developing adenocarcinoma of the vagina, composed of vacuolated and glycogen containing cells, which then describes to you a glandular cell.

    01:50 Another important vaginal tumor with this condition is found in girls less than five years of age.

    01:59 If you were to take a look at the vaginal orifice in this young five-year-old girl, it literally looks like grape-like clusters.

    02:07 We have, technically, an embryonal rhabdomyosarcoma in which the marker for this would be desmin If you remember correctly, a rhabdomyosarcoma will be a skeletal muscle malignancy commonly found in young girls.

    02:27 Sarcoma botryoides, it is an embryonal rhabdomyosarcoma.

    02:33 Description of this, “bunch of grapes or cluster of grapes” upon gross examination.

    About the Lecture

    The lecture Vaginal Cancer by Carlo Raj, MD is from the course Disorders of Vulva, Vagina and Cervix.

    Included Quiz Questions

    1. Squamous cell carcinoma
    2. Vestibular adenitis
    3. Leiomyoma
    4. Obstruction in the ducts of the Bartholin glands
    5. Adenocarcinoma of the intravaginal glands
    1. < 5 years for sarcoma botryoides; 15–20 years for clear cell adenocarcinoma; and > 40 years for squamous cell carcinoma
    2. > 10 years for sarcoma botryoides; 20–30 years for squamous cell carcinoma; and 60–70 years for clear cell adenocarcinoma
    3. < 5 years for clear cell adenocarcinoma, 15–20 years for squamous cell carcinoma; and > 50 years for sarcoma botryoides
    4. < 5 months for clear cell carcinoma; < 30 years for sarcoma botryoides and squamous cell carcinoma
    5. 40–60 years for all types of vaginal neoplasms
    1. Vacuolated, glycogen-containing glandular (columnar) cells
    2. Nests of large eosinophilic squamous cells with intercellular bridges, mitotic figures, and keratin pearls
    3. Pallisading basal cells
    4. A tennis-racket appearance with cytoplasm protruding at 1 end, staining positive for actin
    5. Cells morphologically indistinguishable from normal cells

    Author of lecture Vaginal Cancer

     Carlo Raj, MD

    Carlo Raj, MD

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